Mungovan Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08001044 Issued in IN

Legal business name

MUNGOVAN CHIROPRACTIC PC

Practice address

4705 Illinois Rd Ste 102
Fort Wayne, IN 46804-5108

Phone

(260) 447-1067

Fax

(260) 447-0827

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Michael Thomas Mungovan, DC

Title

Owner

Phone

(260) 447-1067

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365465600000",
    "number": "1154533354",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4705 ILLINOIS RD STE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045108",
            "telephone_number": "260-447-1067",
            "fax_number": "260-447-0827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4705 ILLINOIS RD STE 102",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468045108",
            "telephone_number": "260-447-1067",
            "fax_number": "260-447-0827"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MUNGOVAN CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2013-04-09",
        "status": "A",
        "authorized_official_last_name": "MUNGOVAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-447-1067",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001044",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "226000A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy E Mullins, NP
• Derek Mumaw, DPT
• Christina Marie Mummert, O.D.
• Syed R. Mumtaz, M.D.
• Andrea Mundt, PHARMD
• Michael Thomas Mungovan, DC
• Irfan Munir
• Muneebah Munir, M.D
• Diana Munoz-Mendoza, M.D.
• Linda Genessis Munoz

• Chiropractor in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2013; 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.