Organization Active NPI

Shutt Chiropractic Center, LLC

  • Chiropractor
  • Tarpon Springs, FL
National Provider Identifier
1033200225
Registry record updated May 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH7471 Issued in FL
Legal business name
SHUTT CHIROPRACTIC CENTER, LLC
Practice address
1221 E Tarpon Ave
Tarpon Springs, FL 34689-5441
Phone
(727) 771-8181
Fax
(727) 940-8997
NPI assigned
Sep 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 5, 2014

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

Authorized official

Name
Dr. Michele L Shutt, D.C.
Title
Owner/Physician
Phone
(727) 771-8181

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X CH7471 FL Primary

Addresses

Primary practice location

1221 E Tarpon Ave
Tarpon Springs, FL 34689-5441

Mailing address

1221 E Tarpon Ave
Tarpon Springs, FL 34689-5441
Phone (727) 771-8181

Other identifiers 2

IdentifierTypeStateIssuer
381304500MedicaidFL
K6328OtherFLMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041002000101 FL Part B Supplier - Clinic/Group Practice 9234108598 Receives reassigned benefits from 1 practitioner
Practice locations: Tarpon Springs, FL

National Provider Directory

National Provider Directory

Locations

1221 E Tarpon Ave
Tarpon Springs, FL 34689
Phone (727) 771-8181

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399248000000",
    "number": "1033200225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 E TARPON AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346895441",
            "telephone_number": "727-771-8181",
            "fax_number": "727-940-8997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 E TARPON AVE",
            "city": "TARPON SPRINGS",
            "state": "FL",
            "postal_code": "346895441",
            "telephone_number": "727-771-8181",
            "fax_number": "727-940-8997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHUTT CHIROPRACTIC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2014-05-05",
        "status": "A",
        "authorized_official_last_name": "SHUTT",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "727-771-8181",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH7471",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "381304500",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "K6328",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tarpon Springs, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.