Active NPI
Agave Chiropractic, LLC
- Chiropractor
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5355
- Legal business name
- AGAVE CHIROPRACTIC, LLC
- Practice address
- 3040 N 44TH St
Suite 3
Phoenix, AZ 85018-7225 - Phone
- (602) 956-8736
- Fax
- (602) 956-8769
- NPI assigned
- Jul 19, 2013
- Last updated
- Jul 30, 2013
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Paul Van Berkel, D.C.
- Title
- Owner
- Phone
- (602) 956-8736
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 5355 | AZ | Primary |
Addresses
Primary practice location
3040 N 44TH St
Suite 3
Phoenix, AZ 85018-7225
Mailing address
3040 N 44TH St
Suite 3
Phoenix, AZ 85018-7225
Phone (602) 956-8736
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 1
National Provider Directory
National Provider Directory- Tax ID family
- Agave Chiropractic
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Chiropractor
- Phoenix, AZ
- NPI 1962435966
Locations
3040 N 44th St
Ste 2
Phoenix, AZ 85018
3040 N 44th St
Ste 3
Phoenix, AZ 85018
Phone (602) 730-4332
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Chiropractor
- Phoenix, AZ
- NPI 1902824311
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374192000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1375142400000",
"number": "1982046975",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3040 N 44TH ST",
"address_2": "SUITE 3",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850187225",
"telephone_number": "602-956-8736",
"fax_number": "602-956-8769"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3040 N 44TH ST",
"address_2": "SUITE 3",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850187225",
"telephone_number": "602-956-8736",
"fax_number": "602-956-8769"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AGAVE CHIROPRACTIC, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2013-07-19",
"last_updated": "2013-07-30",
"status": "A",
"authorized_official_last_name": "VAN BERKEL",
"authorized_official_first_name": "PAUL",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "602-956-8736",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AZ",
"license": "5355",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2013; 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.