NPIMap

Organization Active NPI

M5 Chiropractic Professional LLC

  • Chiropractor
  • Littleton, CO
National Provider Identifier
1174719900
Registry record updated Oct 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
5596 Issued in CO
Legal business name
M5 CHIROPRACTIC PROFESSIONAL LLC
Practice address
10789 W Bradford Rd
Ste 110
Littleton, CO 80127-6404
Phone
(303) 904-8641
Fax
(303) 904-8793
NPI assigned
Sep 14, 2007
Last updated
Oct 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2007

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

Authorized official

Name
Mitchell Ryan Moret, D.C.NPI 1609958685
Title
President
Phone
(303) 904-8641

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 5596 CO Primary

Addresses

Primary practice location

10789 W Bradford Rd
Ste 110
Littleton, CO 80127-6404

Mailing address

10789 W Bradford Rd
Ste 110
Littleton, CO 80127-6404
Phone (303) 904-8641

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060214000041 CO Part B Supplier - Clinic/Group Practice 7911912852 Receives reassigned benefits from 1 practitioner
Practice locations: Littleton, CO

National Provider Directory

National Provider Directory

Locations

10789 Bradford Rd
Ste 110
Littleton, CO 80127
Phone (303) 904-8641

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1189728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193702400000",
    "number": "1174719900",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10789 W BRADFORD RD",
            "address_2": "STE 110",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801276404",
            "telephone_number": "303-904-8641",
            "fax_number": "303-904-8793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10789 W BRADFORD RD",
            "address_2": "STE 110",
            "city": "LITTLETON",
            "state": "CO",
            "postal_code": "801276404",
            "telephone_number": "303-904-8641",
            "fax_number": "303-904-8793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M5 CHIROPRACTIC PROFESSIONAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-14",
        "last_updated": "2007-10-30",
        "status": "A",
        "authorized_official_last_name": "MORET",
        "authorized_official_first_name": "MITCHELL",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "303-904-8641",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "5596",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Littleton, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.

Verify at the official NPI Registry.