Individual provider Active NPI

Sharon Marie Dittmer, D.C.

  • Chiropractor
  • Mill Valley, CA
National Provider Identifier
1023183456
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
16341 Issued in CA
Practice address
45 Camino Alto Ste 204
Mill Valley, CA 94941-2935
Phone
(415) 388-7500
NPI assigned
Nov 21, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 16341 CA Primary

Addresses

Primary practice location

45 Camino Alto Ste 204
Mill Valley, CA 94941-2935

Mailing address

45 Camino Alto Ste 204
Mill Valley, CA 94941-2935
Phone (415) 388-7500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000475 CA Practitioner - Chiropractic 5799821765 Practice locations: San Rafael, CA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1982
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

714 C St
San Rafael, CA 94901-4054
Phone (415) 455-8100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16341CAMDGerontology Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023183456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 CAMINO ALTO STE 204",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412935",
            "telephone_number": "415-388-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 CAMINO ALTO STE 204",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412935",
            "telephone_number": "415-388-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTMER",
        "first_name": "SHARON",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "16341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.