Organization Active NPI

5TH Street Associates, Inc

Doing business as associates in chiropractic

  • Nutrition Chiropractor
  • Tucson, AZ
National Provider Identifier
1962581413
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
0078522 Issued in AZ
Legal business name
5TH STREET ASSOCIATES, INC
Doing business as
associates in chiropractic
Practice address
6145 E 5TH St
Tucson, AZ 85711-2505
Phone
(520) 745-1611
Fax
(520) 745-7846
NPI assigned
Nov 3, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Deborah Diane Keleher-Dickerson
Title
Owner/Bookkeeper
Phone
(520) 745-1611

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X 0078522 AZ Primary

Addresses

Primary practice location

6145 E 5TH St
Tucson, AZ 85711-2505

Mailing address

6145 E 5TH St
Tucson, AZ 85711-2505
Phone (520) 745-1611

Other identifiers 3

IdentifierTypeStateIssuer
AZ0234480OtherAZBLUE CROSS
3746055OtherAZACN GROUP
WC28100310OtherAZWORKERS COMPENSATION

Other names 1

  • associates in chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040623001585 AZ Part B Supplier - Clinic/Group Practice 4183609902 Receives reassigned benefits from 1 practitioner
Practice locations: Tucson, AZ

National Provider Directory

National Provider Directory

Locations

1001 N Swan Rd
Tucson, AZ 85711
Phone (520) 323-7133

6145 E 5th St
Tucson, AZ 85711
Phone (520) 207-2832

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962581413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6145 E 5TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112505",
            "telephone_number": "520-745-1611",
            "fax_number": "520-745-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6145 E 5TH ST",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857112505",
            "telephone_number": "520-745-1611",
            "fax_number": "520-745-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "5TH STREET ASSOCIATES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KELEHER-DICKERSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "DIANE",
        "authorized_official_title_or_position": "OWNER/BOOKKEEPER",
        "authorized_official_telephone_number": "520-745-1611",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "AZ",
            "license": "0078522",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "AZ0234480",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN GROUP",
            "identifier": "3746055",
            "state": "AZ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "WC28100310",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "associates in chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tucson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.