Individual provider Active NPI

Joseph Allan Fuller, D.C.

  • Chiropractor
  • Red Lion, PA
National Provider Identifier
1992770531
Registry record updated Feb 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-002379-L Issued in PA
Practice address
631 Lombard Rd
Red Lion, PA 17356-9054
Phone
(717) 840-0888
Fax
(717) 840-4369
NPI assigned
Feb 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-002379-L PA Primary

Addresses

Primary practice location

631 Lombard Rd
Red Lion, PA 17356-9054

Mailing address

631 Lombard Rd
Red Lion, PA 17356-9054
Phone (717) 840-0888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101008000577 PA Practitioner - Chiropractic 6709078785 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1981
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Red Lion Chiropractic, Inc.Group PAC ID 3173500394, 2 clinicians

Practice addresses (Care Compare)

631 Lombard Rd
Red Lion, PA 17356-9054
Phone (717) 840-0888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-002379-LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Red Lion Chiropractic, Inc. Chiropractor CurrentSince Nov 1, 1987 Accepting new patients
Pennsylvania Comprehensive Behavioral Health Services, LLC PastSince Mar 20, 2022 Accepting new patients

Locations

631 Lombard Rd
Red Lion, PA 17356
Phone (717) 840-0888

2555 Cape Horn Rd
Red Lion, PA 17356
Phone (717) 600-0900

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1140134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643846400000",
    "number": "1992770531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 LOMBARD RD",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173569054",
            "telephone_number": "717-840-0888",
            "fax_number": "717-840-4369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 LOMBARD RD",
            "city": "RED LION",
            "state": "PA",
            "postal_code": "173569054",
            "telephone_number": "717-840-0888",
            "fax_number": "717-840-4369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JOSEPH",
        "middle_name": "ALLAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-17",
        "last_updated": "2022-02-03",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-002379-L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Red Lion, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.