Organization Active NPI

Patrick M Bennett D C a Chiropractic Corporation

  • Chiropractor
  • Studio City, CA
National Provider Identifier
1174812200
Registry record updated Mar 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PATRICK M BENNETT D C A CHIROPRACTIC CORPORATION
Practice address
4409 Tujunga Ave
Studio City, CA 91602-2053
Phone
(818) 766-0118
Fax
(818) 766-0078
NPI assigned
Mar 29, 2011
Last updated
Mar 29, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2011

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

Authorized official

Name
Dr. Patrick Michael BennettNPI 1538291778
Title
Owner/President
Phone
(818) 766-0118

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

4409 Tujunga Ave
Studio City, CA 91602-2053

Mailing address

4409 Tujunga Ave
Studio City, CA 91602-2053
Phone (818) 766-0118

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110405000117 CA Part B Supplier - Clinic/Group Practice 6204010929 Receives reassigned benefits from 1 practitioner
Practice locations: Studio City, CA

National Provider Directory

National Provider Directory

Locations

4409 Tujunga Ave
Studio City, CA 91602
Phone (818) 766-0118

Practitioners & affiliated clinicians

Practitioners 2

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": "1301356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1301356800000",
    "number": "1174812200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4409 TUJUNGA AVE",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916022053",
            "telephone_number": "818-766-0118",
            "fax_number": "818-766-0078"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4409 TUJUNGA AVE",
            "city": "STUDIO CITY",
            "state": "CA",
            "postal_code": "916022053",
            "telephone_number": "818-766-0118",
            "fax_number": "818-766-0078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PATRICK M BENNETT D C A CHIROPRACTIC CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-29",
        "last_updated": "2011-03-29",
        "status": "A",
        "authorized_official_last_name": "BENNETT",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "818-766-0118",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Studio City, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; 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.