Active NPI
Richard T Miner, D.C.
- Chiropractor
- Gualala, CA
National Provider Identifier
1174658298
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- DC16750
- Practice address
- 38690 Pacific Dr.
Suite 3
Gualala, CA 95445 - Phone
- (707) 884-1714
- NPI assigned
- Feb 22, 2007
- Last updated
- Jul 8, 2007
- 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 | DC16750 | CA | Primary |
Addresses
Primary practice location
38690 Pacific Dr.
Suite 3
Gualala, CA 95445
Mailing address
PO Box 409
38690 Pacific Dr.
Gualala, CA 95445-0409
Phone (707) 884-1714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110406000596 | CA | Practitioner - Chiropractic | 3274717814 | Practice locations: Auburn, CA; Nevada City, CA |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DC16750 | CA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1174658298",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 409",
"address_2": "38690 PACIFIC DR.",
"city": "GUALALA",
"state": "CA",
"postal_code": "954450409",
"telephone_number": "707-884-1714"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38690 PACIFIC DR.",
"address_2": "SUITE 3",
"city": "GUALALA",
"state": "CA",
"postal_code": "95445",
"telephone_number": "707-884-1714"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINER",
"first_name": "RICHARD",
"middle_name": "T",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "CA",
"license": "DC16750",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gualala, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.