CROTALUS CHIROPRACTIC CENTERS, PLC (NPI# 1073001590) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073001590 |
| Entity Type | Organization |
| Organization Name | CROTALUS CHIROPRACTIC CENTERS, PLC |
| Practice Address |
3540 E Baseline Rd Ste 117 Phoenix AZ 85042-9628 |
| Practice Telephone | 6027777970 |
| Practice Fax Number | 8777716086 |
| Mailing Telephone | 6027777970 |
| Mailing Fax Number | 8777716086 |
| Enumeration Date | 2018-04-30 |
| Last Update Date | 2020-05-22 |
| Authorized Official Name | DR. BRENDAN PATRICK O'CONNOR (DOCTOR OF CHIROPRACTIC) |
| Authorized Official Telephone | 6027777970 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 6095 | AZ | Chiropractic Providers |
| Street Address |
3540 E BASELINE RD STE 117 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85042-9628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306443197 | Da Homes LLC | Case Management | 8026 S. 24th Way, Phoenix, AZ 85042 | 2020-10-05 |
| 1144790460 | Ebony House Inc | Substance Abuse Rehabilitation Facility | 6222 S. 13th Street, Phoenix, AZ 85042 | 2018-11-29 |
| 1427538362 | Abigail Mcgrath | Dietitian, Registered | 303 E Baseline Rd Ste 200, Phoenix, AZ 85042 | 2018-08-20 |
| 1174028310 | Olufemi A Omodara | Pharmacist | 7227 S. Central Ave, #1080, Phoenix, AZ 85042 | 2018-03-29 |
| 1720537699 | Mary Youngblood | Registered Nurse | 7210 S 27th Way, Phoenix, AZ 85042 | 2016-10-03 |
| 1922490382 | Brian Zembower | Optometrist | 610 E Baseline Rd Ste C3, Phoenix, AZ 85042 | 2015-02-23 |
| 1417299819 | Robert Murphy Portley | Psychiatry & Neurology | 2320 E Baseline Rd Ste 148-225, Phoenix, AZ 85042 | 2013-03-23 |
| 1972807998 | Obinna Chukwuka Akubukwe | Pharmacist | 6006 S. Central Avenue, Phoenix, AZ 85042 | 2011-01-05 |
| 1104120328 | Gisheys Patient Care LLC | Custodial Care Facility | 7232 South 12th Place, Phoeniz, AZ 85042 | 2011-01-03 |
| 1245463488 | Lois Ann Hammitt | Registered Nurse | 6218 S. 7th Street, Phoenix, AZ 85042 | 2009-09-03 |
| Find all providers in zip 85042 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023628476 | The Wellness Way North Phoenix LLC | Chiropractor | 34406 N 27th Dr Ste 139, Phoenix, AZ 85085-7733 | 2020-07-31 |
| 1114535366 | Brian Anthony Romero | Chiropractor | 230 S 3rd St Ste B3, Phoenix, AZ 85004-2697 | 2020-07-14 |
| 1760034573 | Teresa Stevens | Chiropractor | 42806 N 20 St, Phoenix, AZ 85087 | 2019-07-11 |
| 1609439645 | Danielle Stetzel | Chiropractor | 1130 E Missouri Ave Ste 402, Phoenix, AZ 85014-2724 | 2019-04-16 |
| 1447723598 | 28th Street Medical Group, LLC | Chiropractor | 2836 E Indian School Rd Ste A8, Phoenix, AZ 85016-6864 | 2019-01-10 |
| 1740753094 | Scott Mackenzie | Chiropractor | 4040 E Camelback Rd Ste 155, Phoenix, AZ 85018-8349 | 2019-01-09 |
| 1417437989 | Lone Star Health, LLC | Chiropractor | 10 E Ruth Ave, Phoenix, AZ 85020-3131 | 2018-08-15 |
| 1477032357 | Joann Moskop | Chiropractor | 2719 N Greenfield Rd., Phoenix, AZ 85006 | 2018-08-10 |
| 1932687969 | Trish Triemert | Chiropractor | 3415 W Glendale Ave Ste 3a, Phoenix, AZ 85051-8484 | 2018-08-01 |
| 1639667009 | Samuel William Rodriguez | Chiropractor | 1130 E Missouri Ave Ste 180, Phoenix, AZ 85014-2736 | 2018-05-01 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.