NPIMap

Organization Active NPI

Embodied Soul Chiropractic

  • Chiropractor
  • Albuquerque, NM
National Provider Identifier
1982152237
Registry record updated Sep 15, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2146 Issued in NM
Legal business name
EMBODIED SOUL CHIROPRACTIC
Practice address
5305 Heritage CT NE
Albuquerque, NM 87109-3178
Phone
(505) 822-5001
NPI assigned
Sep 15, 2016
Last updated
Sep 15, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2016

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

Authorized official

Name
Dr. Randall Adam Polgar, D.C.NPI 1619426251
Title
Doctor of Chiropractic
Phone
(408) 373-1358

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2146 NM Primary

Addresses

Primary practice location

5305 Heritage CT NE
Albuquerque, NM 87109-3178

Mailing address

5305 Heritage CT NE
Albuquerque, NM 87109-3178
Phone (505) 822-5001

National Provider Directory

National Provider Directory

Locations

5305 Heritage Ct NE
Albuquerque, NM 87109
Phone (505) 699-4594

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": "1473897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473897600000",
    "number": "1982152237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5305 HERITAGE CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093178",
            "telephone_number": "505-822-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5305 HERITAGE CT NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871093178",
            "telephone_number": "505-822-5001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMBODIED SOUL CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-15",
        "last_updated": "2016-09-15",
        "status": "A",
        "authorized_official_last_name": "POLGAR",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "408-373-1358",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NM",
            "license": "2146",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albuquerque, NM

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; 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.