NPIMap

Organization Active NPI

Quality Life Chiropractic & Wellness Clinic LLC

  • Chiropractor
  • Springfield, MA
National Provider Identifier
1962841569
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3309 Issued in MA
Legal business name
QUALITY LIFE CHIROPRACTIC & WELLNESS CLINIC LLC
Practice address
1272 Liberty St
Springfield, MA 01104-1153
Phone
(413) 209-1475
NPI assigned
Jun 18, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Dr. Leonardo Samalot, D.C.
Title
Chiropractor
Phone
(413) 209-1475

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3309 MA Primary

Addresses

Primary practice location

1272 Liberty St
Springfield, MA 01104-1153

Mailing address

1272 Liberty St
Springfield, MA 01104-1153
Phone (413) 209-1475

Other identifiers 1

IdentifierTypeStateIssuer
110093148AMedicaidMA

National Provider Directory

National Provider Directory

Locations

1502 Allen St
#105
Springfield, MA 01118
Phone (413) 209-1475

NPI Registry JSON

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

{
    "created_epoch": "1371513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1962841569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1272 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011041153",
            "telephone_number": "413-209-1475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1272 LIBERTY ST",
            "city": "SPRINGFIELD",
            "state": "MA",
            "postal_code": "011041153",
            "telephone_number": "413-209-1475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUALITY LIFE CHIROPRACTIC & WELLNESS CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-18",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "SAMALOT",
        "authorized_official_first_name": "LEONARDO",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "413-209-1475",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110093148A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.