Michaelsen Chiropractic Center, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

F002316 Issued in TX

Legal business name

MICHAELSEN CHIROPRACTIC CENTER, P.C.

Practice address

645 S Broadway Ave
Suite 1
Tyler, TX 75701-1676

Phone

(903) 593-5200

Fax

(903) 535-9412

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Mark R Michaelsen, D.C.NPI 1902832686

Title

President

Phone

(903) 593-5200

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 2

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

• Mark R Michaelsen, DC

  • Chiropractor
  • Tyler, TX
  • NPI 1902832686
  Medicare reassignment Care Compare group NPD Authorized official
• Tammy L Michaelsen, DC

  • Chiropractor
  • Tyler, TX
  • NPI 1659302107
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1358294400000",
    "number": "1053597906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "645 S BROADWAY AVE",
            "address_2": "SUITE 1",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011676",
            "telephone_number": "903-593-5200",
            "fax_number": "903-535-9412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "645 S BROADWAY AVE",
            "address_2": "SUITE 1",
            "city": "TYLER",
            "state": "TX",
            "postal_code": "757011676",
            "telephone_number": "903-593-5200",
            "fax_number": "903-535-9412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAELSEN CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2013-01-16",
        "status": "A",
        "authorized_official_last_name": "MICHAELSEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "903-593-5200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "F002316",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00H42E",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Valere Charly Mfoghom
• Michael C Ford MD, PLLC
• Michael P Goad
• Michael'S House of Hope
• James P Michaels, MD
• Mark R Michaelsen, DC
• Tammy L Michaelsen, DC
• Michele D. Shieldes PLLC
• Michelle Lee Freeze
• Heather Michum

• Chiropractor in Tyler, TX
• Providers in Tyler, TX by specialty
• Chiropractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2013; 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.