Organization Active NPI

Masterson Chiropractic,LLC

  • Chiropractor
  • Warsaw, IN
National Provider Identifier
1053432914
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MASTERSON CHIROPRACTIC,LLC
Practice address
725 E Market St
Warsaw, IN 46580-3313
Phone
(574) 267-7051
Fax
(574) 268-0008
NPI assigned
Apr 2, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Carol L. Masterson
Title
Owner
Phone
(574) 267-7051

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

725 E Market St
Warsaw, IN 46580-3313

Mailing address

725 E Market St
Warsaw, IN 46580-3313
Phone (574) 267-7051

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071219000000 IN Part B Supplier - Clinic/Group Practice 3274623962 Receives reassigned benefits from 1 practitioner
Practice locations: Warsaw, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053432914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 E MARKET ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803313",
            "telephone_number": "574-267-7051",
            "fax_number": "574-268-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 E MARKET ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803313",
            "telephone_number": "574-267-7051",
            "fax_number": "574-268-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MASTERSON CHIROPRACTIC,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MASTERSON",
        "authorized_official_first_name": "CAROL",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-267-7051",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warsaw, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.