NPIMap

Organization Active NPI

Mix-Riddle Chiropractic LLC

Doing business as Discover Chiropractic

  • Chiropractor
  • Trussville, AL
National Provider Identifier
1023753704
Registry record updated Apr 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MIX-RIDDLE CHIROPRACTIC LLC
Doing business as
Discover Chiropractic
Practice address
6381 S Chalkville Rd
Trussville, AL 35173-6304
Phone
(205) 661-6600
Fax
(205) 661-6601
NPI assigned
Apr 28, 2022
Last updated
Apr 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2022

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

Authorized official

Name
Dr. Peter Gilmer Riddle, DCNPI 1326650029
Title
Owner
Phone
(205) 907-5259

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

6381 S Chalkville Rd
Trussville, AL 35173-6304

Mailing address

6381 S Chalkville Rd
Trussville, AL 35173-6304
Phone (205) 661-6600

Other names 1

  • Discover Chiropractic Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL pgriddledc@gmail.com Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220728001082 AL Part B Supplier - Clinic/Group Practice 4981086642 Receives reassigned benefits from 3 practitioners
Practice locations: Trussville, AL

National Provider Directory

National Provider Directory

Locations

6381 S Chalkville Rd
Trussville, AL 35173
Phone (205) 661-6600

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1651104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651104000000",
    "number": "1023753704",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6381 S CHALKVILLE RD",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351736304",
            "telephone_number": "205-661-6600",
            "fax_number": "205-661-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6381 S CHALKVILLE RD",
            "city": "TRUSSVILLE",
            "state": "AL",
            "postal_code": "351736304",
            "telephone_number": "205-661-6600",
            "fax_number": "205-661-6601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIX-RIDDLE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-28",
        "last_updated": "2022-04-28",
        "certification_date": "2022-04-28",
        "status": "A",
        "authorized_official_last_name": "RIDDLE",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "GILMER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "205-907-5259",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "pgriddledc@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "pgriddledc@gmail.com",
            "address_1": "6381 S Chalkville Rd",
            "city": "Trussville",
            "state": "AL",
            "country_code": "US",
            "postal_code": "351736304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Discover Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Trussville, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.