CHIROPRACTIC INJURY CENTER, LLC (NPI# 1932264900) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932264900 |
| Entity Type | Organization |
| Organization Name | CHIROPRACTIC INJURY CENTER, LLC |
| Practice Address |
199 Shirley Ave Revere MA 02151-3258 |
| Practice Telephone | 7814853801 |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | JEFFREY I KELLER (DR. JEFFREY KELLER) |
| Authorized Official Telephone | 7814853801 |
| Authorized Official Credential | D.C. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2403 | MA | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073073904 | Chiropractic Injury Center, LLC | Chiropractor | 11679 Ne Glisan St, Portland, OR 97220-2264 | 2019-03-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | CHIROPRACTIC INJURY CENTER, LLC | 11679 Ne Glisan St, Portland, OR 97220 |
| Massachusetts Corporations | CHIROPRACTIC INJURY CENTER, LLC | 199 Shirley Ave., Revere, MA 02151 |
| Street Address |
199 SHIRLEY AVE |
| City | REVERE |
| State | MA |
| Zip Code | 02151-3258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457335275 | Michael E Pearson | Chiropractor | 199 Shirley Ave, Revere, MA 02151-3258 | 2005-12-05 |
| 1295109171 | King Brangman | Clinic/Center | 199 Shirley Ave, Revere, MA 02151-3258 | 2015-11-16 |
| 1871929281 | Jvl International, Inc | Clinic/Center | 199 Shirley Ave, Revere, MA 02151-3258 | 2013-09-17 |
| 1184927691 | Revere Rehabilitation Center | Chiropractor | 199 Shirley Ave, Revere, MA 02151-3258 | 2010-12-06 |
| 1144385196 | Jeffrey I Keller | Chiropractor | 199 Shirley Ave, Revere, MA 02151-3258 | 2006-12-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558853580 | Carla Richman | Behavioral Analyst | 29 Arnold Street, Revere, MA 02151 | 2018-06-05 |
| 1558859850 | Citizens Physical Therapy Inc | Clinic/Center | 221 Beach St, Revere, MA 02151 | 2018-04-23 |
| 1396254892 | Holness Home Care | Home Health | 959 Revere Beach Parkway, Revere, MA 02151 | 2017-09-27 |
| 1841709938 | Stefanie Finocchio-durham | Acupuncturist | 107 Pearl Ave, Apt 3, Revere, MA 02151 | 2017-09-21 |
| 1174064265 | Hope Noelle Crowe | Behavioral Analyst | 164 Winthrop Parkway, Revere, MA 02151 | 2017-03-09 |
| 1033660469 | Driss Bahraoui | Interpreter | 21 Thornton St #1, Revere, MA 02151 | 2016-10-20 |
| 1568910081 | Lindsey J. Ellermeyer | Student in an Organized Health Care Education/Training Program | Revere Community Counseling, 265 Beach Street, Revere, MA 02151 | 2016-09-13 |
| 1851743470 | Jacqueline Galvez | Counselor | 252 Proctor Ave # 3, Revere, MA 02151 | 2016-07-07 |
| 1518321090 | Kathleen Elizabeth Pellecchia | Health Educator | 454 Broadway Fl 3, Revere, MA 02151 | 2016-04-11 |
| 1780098814 | David A Gross | Internal Medicine | Mgh Revere, 385 Broadway, Revere, MA 02151 | 2014-06-17 |
| Find all providers in zip 02151 | ||||
| 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 |
|---|---|---|---|---|
| 1063584365 | Garry Neal Freedman | Chiropractor | 536 Revere Beach Blvd, Revere, MA 02151-4704 | 2006-11-14 |
| 1144338013 | Luis M Mendonca | Chiropractor | 344 Broadway, Revere, MA 02151-5016 | 2006-08-29 |
| 1073621082 | Metropolitan Chiropractic | Chiropractor | 142 Shirley Ave, Revere, MA 02151 | 2006-08-29 |
| 1134236656 | Spinal Therapy & Chiropractic Services Inc | Chiropractor | 166 Winthrop Ave, Suite 3, Revere, MA 02151-3915 | 2006-08-23 |
| 1457335275 | Michael E Pearson | Chiropractor | 199 Shirley Ave, Revere, MA 02151-3258 | 2005-12-05 |
| 1750670105 | Essential Chiropractic Care LLC | Chiropractor | 454 Broadway, 454 Broadway Suite301, Revere, MA 02151-3034 | 2011-04-06 |
| 1104125285 | Jason Anthony Gambale | Chiropractor | 454 Broadway, Revere, MA 02151-3034 | 2011-03-15 |
| 1053517078 | Essential Care Chiropractic, LLC | Chiropractor | 454 Broadway, Revere, MA 02151-3034 | 2007-06-26 |
| 1841496858 | Anthony Gerard Gambale | Chiropractor | 454 Broadway, Revere, MA 02151 | 2007-06-26 |
| 1134241979 | Broadway Family Chiropractic, Inc | Chiropractor | 85 Broadway, Revere, MA 02151-5302 | 2007-04-04 |
| Find all providers in REVERE | ||||
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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.