Healthways Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC007380L Issued in PA

Legal business name

HEALTHWAYS CHIROPRACTIC PC

Practice address

4125 W Ridge Rd
Erie, PA 16506-1763

Phone

(814) 833-9355

Fax

(814) 833-9355

NPI assigned

Mar 14, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eric Seth Mizuba, DC

Title

Owner/ Doctor

Phone

(814) 833-9355

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1363219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363219200000",
    "number": "1013258151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4125 W RIDGE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061763",
            "telephone_number": "814-833-9355",
            "fax_number": "814-833-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4125 W RIDGE RD",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165061763",
            "telephone_number": "814-833-9355",
            "fax_number": "814-833-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHWAYS CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-14",
        "last_updated": "2013-03-14",
        "status": "A",
        "authorized_official_last_name": "MIZUBA",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "SETH",
        "authorized_official_title_or_position": "OWNER/ DOCTOR",
        "authorized_official_telephone_number": "814-833-9355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007380L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0017864920003",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.