NPIMap

Organization Active NPI

East Valley Physicians Group

Doing business as Red Mountain Chiro-Med

  • Chiropractor
  • Mesa, AZ
National Provider Identifier
1992255798
Registry record updated Oct 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8573 Issued in AZ
Legal business name
EAST VALLEY PHYSICIANS GROUP
Doing business as
Red Mountain Chiro-Med
Practice address
2044 N Recker Rd
Mesa, AZ 85215-2744
Phone
(480) 924-7632
Fax
(480) 924-7622
NPI assigned
Oct 5, 2016
Last updated
Oct 5, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2016

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

Authorized official

Name
David C Ketchum, DC
Title
Owner
Phone
(480) 924-7632

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5173 AZ
Chiropractor 111N00000X 8573 AZ Primary

Addresses

Primary practice location

2044 N Recker Rd
Mesa, AZ 85215-2744

Mailing address

2044 N Recker Rd
Mesa, AZ 85215-2744
Phone (480) 924-7632

Other names 1

  • Red Mountain Chiro-Med Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1475625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1475625600000",
    "number": "1992255798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2044 N RECKER RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852152744",
            "telephone_number": "480-924-7632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2044 N RECKER RD",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852152744",
            "telephone_number": "480-924-7632",
            "fax_number": "480-924-7622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST VALLEY PHYSICIANS GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-05",
        "last_updated": "2016-10-05",
        "status": "A",
        "authorized_official_last_name": "KETCHUM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "480-924-7632",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "5173",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "8573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Mountain Chiro-Med",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.