Individual provider Active NPI

Michael D Daubenspeck, D.C.

  • Chiropractor
  • Lafayette, IN
National Provider Identifier
1093830697
Registry record updated Dec 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001812A Issued in IN
Practice address
40 Professional CT
Lafayette, IN 47905-5152
Phone
(765) 447-2222
Fax
(765) 447-7051
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001812A IN Primary

Addresses

Primary practice location

40 Professional CT
Lafayette, IN 47905-5152

Mailing address

40 Professional CT
Lafayette, IN 47905-5152
Phone (765) 447-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120104000094 IN Practitioner - Chiropractic 6002082625 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08001812AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Pacelli Chiropractic Health Potential Complex Inc Chiropractor CurrentSince Jan 1, 1999 Accepting new patients

Locations

40 Professional Ct
Lafayette, IN 47905
Phone (765) 447-2222

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1702252800000",
    "number": "1093830697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 PROFESSIONAL CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055152",
            "telephone_number": "765-447-2222",
            "fax_number": "765-447-7051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 PROFESSIONAL CT",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055152",
            "telephone_number": "765-447-2222",
            "fax_number": "765-447-7051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAUBENSPECK",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2023-12-11",
        "certification_date": "2023-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001812A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2023; 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.