AUDIT PACK · v2026.05.0

Chiropractor Provider Supply by State

Active U.S. chiropractors per 100,000 residents, by state.

Methodology versionv2026.05.0

Last snapshot2026-05-06

Publisher cadenceQuarterly NPPES refresh; annual Census denominator update.

Spatial resolutionState (50 + DC)

Records97,017 chiropractors

State coverage51 states + DC

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What's in this pack

Source families: CMS NPPES NPI Registry (public API) · U.S. Census Bureau Population Estimates Program (PEP) V2025
Spatial resolution: State (50 + DC). NPPES does not publish a county-level field of practice in its public API.
Temporal coverage: 2026 snapshot (NPPES queried 2026-05-06; Census 2024 vintage).
Publisher cadence: Quarterly NPPES refresh; annual Census denominator update.; this is not proof of the loaded snapshot's currency.
Scope: 97,017 chiropractors across 51 states + DC. Snapshot date: 2026-05-06.

Documented field map

This manifest lists documented fields with source attribution, publisher cadence, and confidence definitions. Runtime records can expose a subset; record-level provenance values may be null or absent. Verbatim source values are confidence 1.0; Fonteum-derived metrics (per-100k, ranks) are 0.95 with the derivation logic below.

Field	Source	Publisher cadence	Confidence
`npi` Individual provider NPI (10-digit).	CMS NPPES NPI Registry (public API)	Quarterly	1.00 ✓
`taxonomy_codes` All NUCC taxonomy codes attached to the record (primary + subspecialties).	CMS NPPES NPI Registry (public API)	Quarterly	1.00 ✓
`taxonomy_primary` The provider's primary NUCC taxonomy code.	CMS NPPES NPI Registry (public API)	Quarterly	1.00 ✓
`state` Practice-address state (USPS code) at the time of NPPES record's last_updated.	CMS NPPES NPI Registry (public API)	Quarterly	1.00 ✓
`city` Practice-address city at the time of NPPES record's last_updated.	CMS NPPES NPI Registry (public API)	Quarterly	1.00 ✓
`last_updated` When CMS last modified the NPPES record. Reflects record freshness, not Fonteum snapshot date.	CMS NPPES NPI Registry (public API)	Quarterly	1.00 ✓
`population_2024` PEP V2025 state population estimate for 2024 vintage.	U.S. Census Bureau Population Estimates Program (PEP) V2025	Annual (V<year> vintage releases each March)	1.00 ✓
`count` chiropractors active in NPPES as of snapshot date. The §193 sub-specialty filter parameter (`?subspecialty=<NUCC code>`) on the public API recomputes counts and density against any registered subspecialty taxonomy.	Fonteum Research (derived from CMS NPPES + U.S. Census Bureau)	Recomputed on each NPPES + Census refresh cycle	0.95
`per_100k` chiropractors per 100,000 residents (count ÷ population × 100,000).	Fonteum Research (derived from CMS NPPES + U.S. Census Bureau)	Recomputed on each NPPES + Census refresh cycle	0.95
`rank_density` 1..51 rank by per_100k across U.S. states + DC.	Fonteum Research (derived from CMS NPPES + U.S. Census Bureau)	Recomputed on each NPPES + Census refresh cycle	0.95
`rank_count` 1..51 rank by absolute count.	Fonteum Research (derived from CMS NPPES + U.S. Census Bureau)	Recomputed on each NPPES + Census refresh cycle	0.95
`quartile` Q1..Q4 from rank_density.	Fonteum Research (derived from CMS NPPES + U.S. Census Bureau)	Recomputed on each NPPES + Census refresh cycle	0.95
`underserved` Boolean: per_100k below the transparent threshold defined in the parent study.	Fonteum Research (derived from CMS NPPES + U.S. Census Bureau) Threshold is a baseline cutoff, not a regulatory or clinical definition.	Recomputed on each NPPES + Census refresh cycle	0.90

Reproducibility statement

A buyer should be able to rerun the methodology against the same public source data and reconcile counts. Discrepancies belong in the corrections log; we publish them when they arise.

1. Query the NPPES API at https://npiregistry.cms.hhs.gov/api/ with taxonomy_description=<NUCC name> and enumeration_type=NPI-1 for each NUCC taxonomy in the parent specialty's scope (full list in the parent study's methodology).
2. Filter results to records with active license status.
3. Bucket by practice-address state (50 USPS codes + DC).
4. Pull U.S. Census Bureau PEP V2025 (2024 vintage) state population estimates from https://www.census.gov/programs-surveys/popest.html.
5. Compute per_100k = count ÷ population × 100,000 per state. Rank ascending and bucket into quartiles by rank.
6. Apply the parent study's transparent underserved threshold to flag the per-state row's underserved boolean.

The full ingest script is published at scripts/research/nppes-write.ts in the Fonteum engine repository (private). Customers under a pilot or Standard agreement can request the script for independent reconciliation.

Limitations

Counts NPI-1 individual providers only; the parent specialty taxonomy plus any subspecialty taxonomies the §183 / §188 ingest scoped to. PAs / NPs / CNMs working in the same care setting under different taxonomy codes are out of scope.
Dataset measures density (per-capita supply), not access. Drive time, appointment availability, insurance acceptance, and wait times are not modeled.
Underserved threshold is the parent study's transparent baseline cutoff, not a regulatory or clinical definition.
Provider state is the practice-address state in NPPES. NPPES does not publish a county-level field of practice in its public API; county queries surface state-level density.
NPPES last_updated reflects when CMS last touched the record — providers may have moved, retired, or changed practice settings without updating their NPPES record. Roughly 5-15% of records have last_updated > 5 years per CMS published quality reports.
U.S. Census Bureau PEP V2025 (2024 vintage) state population. Annual estimates between decennial counts; Census itself documents a confidence band of ~0.5-2% depending on state.
Estimates do not reflect mid-2025+ population movements. Major hurricane / wildfire displacements may distort per-capita ratios for several quarters until next vintage.

Version history

v2026.05.0 · released 2026-05-06
Initial Audit Pack release. Methodology, provenance map, reproducibility statement, and limitations stack baselined.

Compliance Q&A

The most common questions a procurement / compliance officer asks during evaluation. Answers cite source links so the response can be lifted directly into your internal audit document.

Q: What is the source of these provider counts?

The U.S. Centers for Medicare & Medicaid Services NPPES NPI Registry, queried through the public API at npiregistry.cms.hhs.gov. CMS assigns NPIs through NPPES to eligible individuals and organizations. These counts use only public fields and include NPI-1 records carrying the relevant NUCC taxonomy code(s); an NPI or taxonomy entry does not establish licensure, credentialing, Medicare enrollment, or current practice.

Reference: https://npiregistry.cms.hhs.gov/api/

Q: When was this dataset last updated?

Read the dated metadata on the particular study before using it. When checked 2026-07-12, the newest NPPES production system timestamp was 2026-06-10. CMS's publisher schedule does not prove a later Fonteum load completed. The corrections log records published corrections; it is not a universal row-history archive.

Reference: https://fonteum.com/corrections-log

Q: What is excluded?

PAs, nurse practitioners, certified nurse-midwives, and other allied-health providers operating under taxonomy codes outside the parent + scoped subspecialties are excluded. Type-2 organizational NPIs are excluded (the dataset is per-physician, not per-practice). Out-of-state telemedicine attribution is not separable from in-state practice in the public NPPES record.

Reference: https://fonteum.com/methodology

Q: How is the underserved threshold defined?

Each study's underserved threshold is a transparent baseline cutoff stated explicitly in the methodology. It is not a regulatory or clinical definition. Where applicable, thresholds are aligned with HRSA HPSA shortage criteria or specialty-society workforce reports; the methodology page shows the rationale per study.

Reference: https://fonteum.com/methodology

Q: Can I reproduce these counts independently?

Yes. The reproducibility statement above lists the exact NPPES API query parameters, the Census 2024-vintage population denominators, and the per-state aggregation logic. A buyer can rerun the methodology against the same source data and reconcile counts. We document any discrepancies in the corrections log when they arise.

Reference: https://fonteum.com/corrections-log

Q: Does this dataset measure access or just density?

Density only. Per-capita supply is not the same as patient access. Drive time, appointment availability, insurance acceptance, telemedicine substitution, and wait times are not modeled in the dataset. The Limitations section calls this out explicitly so it cannot be misread as an access claim.

Reference: https://fonteum.com/methodology#limitations

Q: What is the licensing scope of this data?

The underlying NPPES + Census data is public-domain federal information. Fonteum Research's aggregated dataset (the per-state counts + denominators + ranks) is licensed under the Fonteum editorial-policy terms — internal use during a pilot agreement, commercial-product use under a Standard or Enterprise contract. Resyndication to third parties requires a separate agreement.

Reference: https://fonteum.com/terms

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Pilot, Standard, and Enterprise customers receive Audit Packs scoped to their delivery cadence and contracted dataset list. The methodology version is pinned to the snapshot delivered, so the artifact is durable across the contract period. Contact pilot@fonteum.com or request access at /pilot-intake.

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