Back to Basics Chiropractic
Organization Active NPI Chiropractor · Keaau, HI
NPI 1992290811 · NPPES record last updated Jul 23, 2018
Key facts
- NPI
- 1992290811
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- DC-1332 (HI)
- Legal business name
- BACK TO BASICS CHIROPRACTIC
- Practice address
- 16-590 Old Volcano Rd
Keaau, HI 96749 - Phone
- (408) 809-1844
- NPI assigned
- Jun 22, 2018
- Organization subpart
- No
Authorized official
- Name
- Deirdre Imagire
- Title
- Owner/Manager
- Phone
- (408) 809-1844
Practitioners 4
-
Nolan Hirota, D.C.
-
Alec Adamski, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in HI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180724003834 | HI | Part B Supplier - Clinic/Group Practice | 2466709209 |
Receives reassigned benefits from 3 practitioners Practice locations: Keaau, HI; Pahoa, HI |
National Provider Directory
Locations
16-590 Old Volcano Rd
Ste D
Keaau, HI 96749
Phone (408) 809-1844
16-590 Old Volcano Rd
Keaau, HI 96749
Phone (808) 966-7942
15-2131 Keaau Pahoa Rd
Pahoa, HI 96778
Phone (408) 809-1844
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | DC-1332 | HI | Yes |
Addresses
Primary practice location
16-590 Old Volcano Rd
Keaau, HI 96749
Mailing address
16-590 Old Volcano Rd
Keaau, HI 96749-8158
Phone (408) 809-1844
Other practice location 1
15-2131 Keaau Pahoa Rd
Pahoa, HI 96778-7799
Phone (408) 809-1844
Other providers in Keaau, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 23, 2018. 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.