NPIMap

Organization Active NPI

Back to Basics Chiropractic

  • Chiropractor
  • Kea'au, HI
National Provider Identifier
1992290811
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-1332 Issued in 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
Last updated
Jul 23, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Authorized official

Name
Deirdre Imagire
Title
Owner/Manager
Phone
(408) 809-1844

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC-1332 HI Primary

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

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180724003834 HI Part B Supplier - Clinic/Group Practice 2466709209 Receives reassigned benefits from 3 practitioners
Practice locations: Keaau, HI; Pahoa, HI

National Provider Directory

National Provider Directory

Locations

16-590 Old Volcano Rd
Keaau, HI 96749
Phone (808) 966-7942

16-590 Old Volcano Rd
Ste D
Keaau, HI 96749
Phone (408) 809-1844

15-2131 Keaau Pahoa Rd
Pahoa, HI 96778
Phone (408) 809-1844

Practitioners & affiliated clinicians

Practitioners 4

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": "1529625600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1532304000000",
    "number": "1992290811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16-590 OLD VOLCANO RD",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "967498158",
            "telephone_number": "408-809-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16-590 OLD VOLCANO RD",
            "city": "KEAAU",
            "state": "HI",
            "postal_code": "96749",
            "telephone_number": "408-809-1844"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15-2131 Keaau Pahoa Rd",
            "address_purpose": "LOCATION",
            "city": "Pahoa",
            "state": "HI",
            "postal_code": "967787799",
            "country_code": "US",
            "telephone_number": "408-809-1844",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BACK TO BASICS CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-22",
        "last_updated": "2018-07-23",
        "status": "A",
        "authorized_official_last_name": "IMAGIRE",
        "authorized_official_first_name": "DEIRDRE",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "408-809-1844"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "HI",
            "license": "DC-1332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kea'au, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2018; 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.

Verify at the official NPI Registry.