Beech Grove Chiropractic, Inc P.C.
Organization Active NPI Chiropractor · Indianapolis, IN
NPI 1962629972 · NPPES record last updated Oct 31, 2014
Key facts
- NPI
- 1962629972
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08001592 (IN)
- Legal business name
- BEECH GROVE CHIROPRACTIC, INC P.C.
- Practice address
- 3850 South Emerson Avenue
Suite F
Indianapolis, IN 46203-5997 - Phone
- (317) 788-0227
- Fax
- (317) 788-0246
- NPI assigned
- Apr 19, 2007
- Organization subpart
- No
Authorized official
- Name
- Richard Walter James, D. C.
- Title
- Insurance
- Phone
- (317) 788-0227
Practitioners 2
-
Nereida Viera, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20141113001870 | IN | Part B Supplier - Clinic/Group Practice | 2860614591 |
Receives reassigned benefits from 1 practitioner Practice locations: Indianapolis, IN |
National Provider Directory
Locations
3850 S Emerson Ave
Ste F
Indianapolis, IN 46203
Phone (317) 788-0227
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 08001592 | IN | Yes |
Addresses
Primary practice location
3850 South Emerson Avenue
Suite F
Indianapolis, IN 46203-5997
Mailing address
3850 S Emerson Avenue
Suite F
Indianapolis, IN 46203-5997
Phone (317) 788-0227
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200028020A | Medicaid | IN |
Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 31, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.