{"npi":"1740405604","type":"NPI-2","status":"active","name":{"display":"North East Chiropractic PA","other":[],"organization_name":"NORTH EAST CHIROPRACTIC PA","authorised_official":"Heather Blackiston"},"specialty":{"primary_taxonomy":"111N00000X","primary_taxonomy_description":"Chiropractor","slug":"chiropractor","schema_org_specialty":null,"all":[{"code":"225100000X","description":"Physical Therapist","primary":false,"state":"MD","license":"02079"},{"code":"111N00000X","description":"Chiropractor","primary":true,"state":"MD","license":"02079"}]},"addresses":[{"purpose":"LOCATION","street_1":"2316 PULASKI HWY STE B","city":"NORTH EAST","state":"MD","postal_code":"219013730","country_code":"US","phone":"4106429110","fax":"4106429113"},{"purpose":"MAILING","street_1":"2316 PULASKI HWY STE B","city":"NORTH EAST","state":"MD","postal_code":"219013730","country_code":"US","phone":"4106429110","fax":"4106429113"}],"license":{"state":"MD","number":"02079"},"identifiers":[{"type_code":"01","label":"Other","value":"61670301","state":"MD","issuer":"BC RENDERING PROV. ID"},{"type_code":"01","label":"Other","value":"2912304","state":"MD","issuer":"AETNA PROV. ID"}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20080304000317","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"MD","pac_id":"2163507963"}]},"enumeration_date":"2007-04-16","last_updated":"2021-03-16","_meta":{"source":"NPPES","snapshot_date":"2021-03-16","doc_url":"https://findmynpi.com/api"}}