Organization Active NPI

Maillette Chiropractic PC

  • Chiropractor
  • Bay City, MI
National Provider Identifier
1104871110
Registry record updated Aug 22, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MAILLETTE CHIROPRACTIC PC
Practice address
3400 Wilder Rd
Bay City, MI 48706-2331
Phone
(989) 667-9700
Fax
(989) 667-9701
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2013

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

Authorized official

Name
Dr. Eric J Maillette, DCNPI 1861447468
Title
Owner
Phone
(989) 667-9700

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3400 Wilder Rd
Bay City, MI 48706-2331

Mailing address

3400 Wilder Rd
Bay City, MI 48706-2331
Phone (989) 667-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040807000100 MI Part B Supplier - Clinic/Group Practice 2264404532 Receives reassigned benefits from 2 practitioners
Practice locations: Bay City, MI

National Provider Directory

National Provider Directory

Locations

3916 Traxler Ct
Ste A
Bay City, MI 48706
Phone (989) 667-9700

Practitioners & affiliated clinicians

Practitioners 2

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377129600000",
    "number": "1104871110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 WILDER RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487062331",
            "telephone_number": "989-667-9700",
            "fax_number": "989-667-9701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3400 WILDER RD",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487062331",
            "telephone_number": "989-667-9700",
            "fax_number": "989-667-9701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAILLETTE CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2013-08-22",
        "status": "A",
        "authorized_official_last_name": "MAILLETTE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-667-9700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay City, MI

Sources for this page

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