Organization Active NPI

Ackerman Chiropractic & Fitness Center, LLC

  • Chiropractor
  • Wadesville, IN
National Provider Identifier
1154650406
Registry record updated Dec 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001203A Issued in IN
Legal business name
ACKERMAN CHIROPRACTIC & FITNESS CENTER, LLC
Practice address
7125 Hwy 66
Wadesville, IN 47638-9635
Phone
(812) 673-4947
Fax
(812) 673-4846
NPI assigned
Dec 16, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 16, 2009

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

Authorized official

Name
Dwayne A Ackerman, DCNPI 1386733525
Title
Ceo
Phone
(812) 673-4947

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 SINGLE SPECIALTY GROUP 111N00000X 08001203A IN Primary

Addresses

Primary practice location

7125 Hwy 66
Wadesville, IN 47638-9635

Mailing address

P O Box 123
Wadesville, IN 47638-0123
Phone (812) 673-4947

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091207000457 IN Part B Supplier - Clinic/Group Practice 0345389243 Receives reassigned benefits from 1 practitioner
Practice locations: Wadesville, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1260921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1260921600000",
    "number": "1154650406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P O BOX 123",
            "city": "WADESVILLE",
            "state": "IN",
            "postal_code": "476380123",
            "telephone_number": "812-673-4947",
            "fax_number": "812-673-4846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7125 HWY 66",
            "city": "WADESVILLE",
            "state": "IN",
            "postal_code": "476389635",
            "telephone_number": "812-673-4947",
            "fax_number": "812-673-4846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACKERMAN CHIROPRACTIC & FITNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-16",
        "last_updated": "2009-12-16",
        "status": "A",
        "authorized_official_last_name": "ACKERMAN",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "812-673-4947",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001203A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wadesville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2009; 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.