NPIMap

Organization Active NPI

Mountain View Chiropractic

  • Chiropractor
  • Wasilla, AK
National Provider Identifier
1083733737
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
308 Issued in AK
Legal business name
MOUNTAIN VIEW CHIROPRACTIC
Practice address
5461 E Mayflower #6
Wasilla, AK 99654
Phone
(907) 357-6688
Fax
(907) 357-9655
NPI assigned
Mar 27, 2007
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. Diane Michele Deshazo
Title
Owner
Phone
(907) 357-6688

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 308 AK Primary

Addresses

Primary practice location

5461 E Mayflower #6
Wasilla, AK 99654

Mailing address

7758 N Goldcord Circle
Palmer, AK 99645
Phone (907) 357-6688

Other identifiers 1

IdentifierTypeStateIssuer
CH03081MedicaidAK

National Provider Directory

National Provider Directory

Locations

2414 Mill Bay Rd
Ste 1
Kodiak, AK 99615
Phone (907) 486-4042

Practitioners & affiliated clinicians

Practitioners 11

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": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1083733737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7758 N GOLDCORD CIRCLE",
            "city": "PALMER",
            "state": "AK",
            "postal_code": "99645",
            "telephone_number": "907-357-6688",
            "fax_number": "907-357-9655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5461 E MAYFLOWER #6",
            "city": "WASILLA",
            "state": "AK",
            "postal_code": "99654",
            "telephone_number": "907-357-6688",
            "fax_number": "907-357-9655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN VIEW CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DESHAZO",
        "authorized_official_first_name": "DIANE",
        "authorized_official_middle_name": "MICHELE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "907-357-6688",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "AK",
            "license": "308",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CH03081",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wasilla, AK

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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.