Porter County Chiropractic Clinic Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08001767A Issued in IN

Legal business name

PORTER COUNTY CHIROPRACTIC CLINIC INC.

Practice address

2600 Roosevelt Rd
Valparaiso, IN 46383-0970

Phone

(219) 465-5015

Fax

(219) 548-3828

NPI assigned

Nov 23, 2005

Organization subpart

No

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

Authorized official

Name

Dr. Dale L Beauvais, DCNPI 1760506554

Title

Owner

Phone

(219) 465-5015

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dale Lee Beauvais, DC

  • Chiropractor
  • Valparaiso, IN
  • NPI 1760506554
  Medicare reassignment NPD Authorized official
• Brian T Cassani, DC

  • Chiropractor
  • Valparaiso, IN
  • NPI 1366404956
  NPD (past)
• John Emmanuel Kazonis, D.C.

  • Chiropractor
  • Valparaiso, IN
  • NPI 1467491209
  NPD (past)
• John Nick Kostidis, D.C.

  • Chiropractor
  • Valparaiso, IN
  • NPI 1639128929
  NPD (past)

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

{
    "created_epoch": "1132704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1435536000000",
    "number": "1144203183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1009",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463841009",
            "telephone_number": "219-465-5015",
            "fax_number": "219-548-3828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 ROOSEVELT RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463830970",
            "telephone_number": "219-465-5015",
            "fax_number": "219-548-3828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER COUNTY CHIROPRACTIC CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-23",
        "last_updated": "2015-06-29",
        "status": "A",
        "authorized_official_last_name": "BEAUVAIS",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "219-465-5015",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001767A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE GROUP NO",
            "identifier": "350049047",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL BC/BS GROUP NUMBER",
            "identifier": "90000986",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "000000105239",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200208460A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anand P Popli, MD
• Portage Township Porter County (Portage Township Ambulance)
• Porter
• Porter County Anesthesia Associates PC
• Porter County Auditors Office (Porter County Health Department)
• Porter County Community Services, Inc
• Porter County Endoscopy Center, LLC (Endolabs)
• Porter County Family Counseling Center
• Porter County Family Counseling Center
• Porter County Internal Medicine PC

• Chiropractor in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2015; 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.