Individual provider Active NPI

Christopher L. Mirabella, D.C.

  • Chiropractor
  • Woodland Park, CO
National Provider Identifier
1174575534
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5875 Issued in CO
Practice address
800 E US Highway 24
Suite D
Woodland Park, CO 80863-7754
Phone
(719) 687-1881
NPI assigned
May 16, 2006
Last updated
Oct 2, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 5875 CO Primary

Addresses

Primary practice location

800 E US Highway 24
Suite D
Woodland Park, CO 80863-7754

Mailing address

800 E US Highway 24
Suite D
Woodland Park, CO 80863-7754
Phone (719) 687-1881

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060809000167 CO Practitioner - Chiropractic 0547263790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Los Angeles College of Chiropractic, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

800 E US Hwy 24
Suite D
Woodland Park, CO 80863-7755

800 E US Hwy 24 D
Woodland Park, CO 80863-7755
Phone (719) 687-1881

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5875COMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Teller County Chiropractic Chiropractor CurrentSince May 19, 2006 Accepting new patients

Locations

800 E US Highway 24
Ste D
Woodland Park, CO 80863
Phone (719) 687-1881

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1174575534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E US HIGHWAY 24",
            "address_2": "SUITE D",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808637754",
            "telephone_number": "719-687-1881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E US HIGHWAY 24",
            "address_2": "SUITE D",
            "city": "WOODLAND PARK",
            "state": "CO",
            "postal_code": "808637754",
            "telephone_number": "719-687-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRABELLA",
        "first_name": "CHRISTOPHER",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodland Park, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.