Active NPI
Michael Edwin Clayton Anderson, D.C.
- Chiropractor
- Mesquite, TX
National Provider Identifier
1114103116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 10804
- Practice address
- 210 W Davis St Ste 100
Mesquite, TX 75149-4648 - Phone
- (972) 807-9355
- NPI assigned
- Jan 21, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 10804 | TX | Primary |
Addresses
Primary practice location
210 W Davis St Ste 100
Mesquite, TX 75149-4648
Mailing address
210 West Davis Street Suite 100
Mesquite, TX 75149
Phone (972) 807-9355
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 111N00000X | Other | TX | CHIROPRACTOR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10804 | TX | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Terrell Chiropractic Spine & Injury Clinic | Past | Accepting new patients |
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.
-
- Clinic/Center
- Terrell, TX
- NPI 1750788394
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200873600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1579046400000",
"number": "1114103116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "210 WEST DAVIS STREET SUITE 100",
"city": "MESQUITE",
"state": "TX",
"postal_code": "75149",
"telephone_number": "972-807-9355"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 W DAVIS ST STE 100",
"city": "MESQUITE",
"state": "TX",
"postal_code": "751494648",
"telephone_number": "972-807-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANDERSON",
"first_name": "MICHAEL",
"middle_name": "EDWIN CLAYTON",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-01-21",
"last_updated": "2020-01-15",
"certification_date": "2020-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "10804",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CHIROPRACTOR",
"identifier": "111N00000X",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Mesquite, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 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.