Dr Shideler PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08000719 Issued in IN

Legal business name

DR SHIDELER PC

Practice address

753 N Main St
Bluffton, IN 46714-1313

Phone

(260) 824-0318

NPI assigned

Jan 30, 2012

Last updated

Jan 30, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Randy Shideler, DCNPI 1881818391

Title

President

Phone

(260) 824-0318

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 1

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.

• Randy James Shideler, D.C.

  • Chiropractor
  • Bluffton, IN
  • NPI 1881818391
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1327881600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1327881600000",
    "number": "1174895742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467141313",
            "telephone_number": "260-824-0318"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "753 N MAIN ST",
            "city": "BLUFFTON",
            "state": "IN",
            "postal_code": "467141313",
            "telephone_number": "260-824-0318"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR SHIDELER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-30",
        "last_updated": "2012-01-30",
        "status": "A",
        "authorized_official_last_name": "SHIDELER",
        "authorized_official_first_name": "RANDY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "260-824-0318",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08000719",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000183222",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100054940A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Darryl L. Coty, D.C.
• Decatur Dental Services, Inc. (Bluffton Dental Clinic)
• Ashleigh Jenae Detray
• Donald August Dian, MD
• Mary C Donley, MD
• Rachel K Draper, MA
• Duane a Nodine DDS Inc
• Ashwani Duggal, M.D.
• Robert William Duncan, D.C.
• Ear, Nose & Throat Associates, PC

• Chiropractor in Bluffton, IN
• Providers in Bluffton, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2012; 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.