Active NPI
Corlin Alden Stein, DC
- Chiropractor
- St. John, IN
National Provider Identifier
1053406629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08001477
- Practice address
- 9161 Wicker Avenue (US 41)
St. John, IN 46373 - Phone
- (219) 365-4777
- Fax
- (219) 365-0267
- NPI assigned
- Oct 3, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08001477 | IN | Primary |
Addresses
Primary practice location
9161 Wicker Avenue (US 41)
St. John, IN 46373
Mailing address
9161 Wicker Avenue (US 41)
P.O. Box 298
St. John, IN 46373
Phone (219) 365-4777
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000000090043 | Other | BC/BS PROVIDER NUMBER | |
| P00092338 | Other | IN | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040610001480 | IN | Practitioner - Chiropractic | 0648253591 | Practice locations: St John, IN |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
9161 Wicker Ave
Saint John, IN 46373-9781
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08001477 | IN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1053406629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9161 WICKER AVENUE (US 41)",
"address_2": "P.O. BOX 298",
"city": "ST. JOHN",
"state": "IN",
"postal_code": "46373",
"telephone_number": "219-365-4777",
"fax_number": "219-365-0267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9161 WICKER AVENUE (US 41)",
"city": "ST. JOHN",
"state": "IN",
"postal_code": "46373",
"telephone_number": "219-365-4777",
"fax_number": "219-365-0267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEIN",
"first_name": "CORLIN",
"middle_name": "ALDEN",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08001477",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS PROVIDER NUMBER",
"identifier": "000000090043",
"state": null
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "P00092338",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in St. John, IN
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.