NPIMap

Organization Active NPI

Optimal Health Chiropractic P. C.

  • Chiropractor
  • Berlin, MD
National Provider Identifier
1174795124
Registry record updated Sep 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03542 Issued in MD
Legal business name
OPTIMAL HEALTH CHIROPRACTIC P. C.
Practice address
9956 N Main St
Suite 4
Berlin, MD 21811-1077
Phone
(410) 629-1845
Fax
(410) 629-1846
NPI assigned
Mar 31, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2008

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

Authorized official

Name
Dr. Jeffery Charles Michael, D.C.NPI 1710171236
Title
Owner/President
Phone
(410) 714-1553

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 03542 MD Primary

Addresses

Primary practice location

9956 N Main St
Suite 4
Berlin, MD 21811-1077

Mailing address

9956 N Main St
Suite 4
Berlin, MD 21811-1077
Phone (410) 629-1845

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20081007000077 MD Part B Supplier - Clinic/Group Practice 2163590936 Receives reassigned benefits from 4 practitioners
Practice locations: Berlin, MD

National Provider Directory

National Provider Directory

Locations

9956 N Main St
Unit 4
Berlin, MD 21811
Phone (410) 629-1845

Practitioners & affiliated clinicians

Practitioners 4

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": "1206921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222300800000",
    "number": "1174795124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9956 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111077",
            "telephone_number": "410-629-1845",
            "fax_number": "410-629-1846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9956 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111077",
            "telephone_number": "410-629-1845",
            "fax_number": "410-629-1846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL HEALTH CHIROPRACTIC P. C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-31",
        "last_updated": "2008-09-25",
        "status": "A",
        "authorized_official_last_name": "MICHAEL",
        "authorized_official_first_name": "JEFFERY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "410-714-1553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "03542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2008; 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.