Bangor Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC007480L Issued in PA

Legal business name

BANGOR CHIROPRACTIC, INC.

Practice address

55 Broadway
Bangor, PA 18013-1706

Phone

(610) 588-6199

Fax

(610) 588-1497

NPI assigned

Oct 26, 2006

Last updated

Feb 23, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Michael Thomas Bauer, D.C.NPI 1154406528

Title

President

Phone

(610) 588-6199

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Practitioners 1

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.

• Michael Thomas Bauer, D.C.

  • Chiropractor
  • Bangor, PA
  • NPI 1154406528
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329955200000",
    "number": "1033294418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 BROADWAY",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131706",
            "telephone_number": "610-588-6199",
            "fax_number": "610-588-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 BROADWAY",
            "city": "BANGOR",
            "state": "PA",
            "postal_code": "180131706",
            "telephone_number": "610-588-6199",
            "fax_number": "610-588-1497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BANGOR CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2012-02-23",
        "status": "A",
        "authorized_official_last_name": "BAUER",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "610-588-6199",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007480L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK BS",
            "identifier": "617339",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7498329",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Amator, MS, MA
• Amber Petchonka
• Gregory Vaughan Appleton
• Elizabeth Rafiha Araman, M.S. CCC-SLP
• Bangor Area School District
• Bangor Medical Center Inc PC
• Bangor Podiatry LLC
• Patricia G Baranowski, MA, CADC
• Michael Thomas Bauer, D.C.
• Joyce Anna Beery, PHARMD

• Chiropractor in Bangor, PA
• Providers in Bangor, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2012; 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.