Organization Active NPI

Pike Creek Chiropractic P.a.

  • Chiropractor
  • Newark, DE
National Provider Identifier
1992917025
Registry record updated Aug 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
F1-0000210 Issued in DE
Legal business name
PIKE CREEK CHIROPRACTIC P.A.
Practice address
1450 Capitol TRL
Suite #103
Newark, DE 19711-5700
Phone
(302) 737-9601
Fax
(302) 737-9604
NPI assigned
May 3, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2011

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

Authorized official

Name
Dr. Robert Christopher South, D.C.NPI 1578697934
Title
President
Phone
(302) 737-9601

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X F1-0000210 DE Primary

Addresses

Primary practice location

1450 Capitol TRL
Suite #103
Newark, DE 19711-5700

Mailing address

1450 Capitol TRL
Suite #103
Newark, DE 19711-5700
Phone (302) 737-9601

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110906000064 DE Part B Supplier - Clinic/Group Practice 2264602036 Receives reassigned benefits from 1 practitioner
Practice locations: Newark, DE

National Provider Directory

National Provider Directory

Locations

1450 Capitol Trl
Ste 103
Newark, DE 19711
Phone (302) 737-9601

1450 Capitol Trl
Ste 106
Newark, DE 19711

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1314576000000",
    "number": "1992917025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 CAPITOL TRL",
            "address_2": "SUITE #103",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197115700",
            "telephone_number": "302-737-9601",
            "fax_number": "302-737-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 CAPITOL TRL",
            "address_2": "SUITE #103",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197115700",
            "telephone_number": "302-737-9601",
            "fax_number": "302-737-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIKE CREEK CHIROPRACTIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2011-08-29",
        "status": "A",
        "authorized_official_last_name": "SOUTH",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "302-737-9601",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000210",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2011; 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.