WALCOTT CHIROPRACTIC, P.C. (NPI# 1336175918) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336175918 |
| Entity Type | Organization |
| Organization Name | WALCOTT CHIROPRACTIC, P.C. |
| Other Organization Name | ADVANCED WELLNESS CENTER OF PA |
| Practice Address |
14260 Bustleton Ave Philadelphia PA 19116-1108 |
| Mailing Address |
1548 Revere Rd Yardley PA 19067-4351 |
| Practice Telephone | 2156760104 |
| Mailing Telephone | 2154931590 |
| Enumeration Date | 2006-06-24 |
| Last Update Date | 2008-01-28 |
| Authorized Official Name | DR. CHRISTOPHER VAILL WALCOTT (PRESIDENT) |
| Authorized Official Telephone | 2154931590 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | DC007908L | PA | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PA | BLUE SHIELD | 056172 | 01 |
| PA | BLUE SHIELD GROUP ID | 1437125 | 01 |
| PA | RR MEDICARE | P00240657 | 01 |
| PA | KEYSTONE | 0060935000 | 01 |
| PA | RR MEDICARE GROUP ID | DD6376 | 01 |
| PA | AMERIHEALTH PIN ID | 0060935000 | 01 |
| PA | KEYSTONE GROUP ID | 2125718000 | 01 |
| PA | PERSONAL CHOICE | 0060935000 | 01 |
| PA | PERSONAL CHOICE GROUP ID | 2125718000 | 01 |
| PA | UNITED HEALTHCARE | 2192178 | 01 |
| PA | AETNA HMO | 3063269 | 01 |
| PA | AETNA TRADITIONAL | 7979272 | 01 |
| Other Name | Type Code |
|---|---|
| Advanced Wellness Center of PA | Doing Business As Name - Organization |
| Street Address |
14260 BUSTLETON AVE |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19116-1108 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194334466 | Ambassador Home Care Services LLC | Homemaker | 118080 Bustleton Av, Suite 301, Philadelphia, PA 19116 | 2020-07-23 |
| 1669919445 | Lenore Pierce Bailey | Social Worker | 15100 Dahlia Drive, Philadelphia, PA 19116 | 2017-01-31 |
| 1477938991 | Jessica Gabriela Dashevsky | Counselor | 467 Parlin St, Philadelphia, PA 19116 | 2015-07-27 |
| 1174949697 | Absolute Therapy Care LLC | Physical Therapist | 10125 Verree Rd Ste 100, Philadelphia, PA 19116 | 2014-03-07 |
| 1790107936 | Philmont Homecare, LLC | Home Health | 14500 Bustleton Avenue, Suite 208, Philadelphia, PA 19116 | 2014-01-07 |
| 1417381609 | Able Ambulance Inc. | Ambulance | 1017 Haldeman Ave., Philadelphia, PA 19116 | 2013-08-25 |
| 1821356718 | Timur Kakhramanov | Nurse Practitioner | 301 W.byberry Rd, Unit F-6, Philadelphia, PA 19116 | 2012-04-27 |
| 1982975173 | Simon Perelshteyn | Internal Medicine | 10172 Verree Rd, Philadelphia, PA 19116 | 2012-01-19 |
| 1841574449 | Irene Feldman | Pharmacist | 10000 Busteloton Ave, Philadelphia, PA 19116 | 2011-10-03 |
| 1992095590 | Long Life Ambulance, LLC | Ambulance | 10065 Sandmeyer Lane, 103, Philadelphia, PA 19116 | 2011-04-15 |
| Find all providers in zip 19116 | ||||
| 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 |
|---|---|---|---|---|
| 1124628540 | Citywide North, PC | Chiropractor | 2304-a North Broad Street, Philadelphia, PA 19132-4563 | 2020-10-26 |
| 1598313488 | Dev Avinash Rajhansa | Chiropractor | 101 W Allens Ln, Philadelphia, PA 19119-4101 | 2019-09-03 |
| 1861059859 | Joshua James Kramarenko | Chiropractor | 1608 Walnut St Ste 601, Philadelphia, PA 19103-5447 | 2019-05-24 |
| 1306409024 | Danielle Louise Walsh | Chiropractor | 3500 Scotts Ln Ste 215, Philadelphia, PA 19129-1836 | 2019-04-18 |
| 1952868804 | Yoon Sang Song | Chiropractor | 6115 Woodland Ave, Philadelphia, PA 19142-2418 | 2019-02-27 |
| 1104381011 | Anthony James Havens Jr. | Chiropractor | 6006 Chestnut St Fl 1, Philadelphia, PA 19139-3044 | 2019-02-05 |
| 1750851390 | Philadelphia Pain and Neurology Institute, LLC | Chiropractor | 1528 Walnut Street Suite 620, Philadelphia, PA 19102 | 2018-11-27 |
| 1710467626 | Darin Mathew Daniel | Chiropractor | 2216 W Passyunk Ave, Philadelphia, PA 19145-3318 | 2018-08-20 |
| 1780184952 | Chelsea Ann Mclane | Chiropractor | 430 Green Ln, Philadelphia, PA 19128-3304 | 2018-02-14 |
| 1881193860 | Pa Pain and Rehab | Chiropractor | 6325 Woodland Avenue, Philadelphia, PA 19142 | 2018-02-06 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19116 |
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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.