NPIMap

Organization Active NPI

Hudak Chiropractic Clinic, PC

  • Chiropractor
  • Saint Joseph, MI
National Provider Identifier
1225087018
Registry record updated Jul 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HUDAK CHIROPRACTIC CLINIC, PC
Practice address
804 Elm St
Saint Joseph, MI 49085-1227
Phone
(269) 983-5527
Fax
(269) 983-3610
NPI assigned
May 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2007

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

Authorized official

Name
Dr. Erik T Hudak, D.C.NPI 1487603288
Title
President
Phone
(269) 983-5527

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 Primary

Addresses

Primary practice location

804 Elm St
Saint Joseph, MI 49085-1227

Mailing address

804 Elm St
Saint Joseph, MI 49085-1227
Phone (269) 983-5527

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040505000391 MI Part B Supplier - Clinic/Group Practice 2264420579 Receives reassigned benefits from 3 practitioners
Practice locations: St Joseph, MI

National Provider Directory

National Provider Directory

Locations

804 Elm St
Saint Joseph, MI 49085
Phone (269) 983-5527

Practitioners & affiliated clinicians

Practitioners 5

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": "1147132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185148800000",
    "number": "1225087018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 ELM ST",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851227",
            "telephone_number": "269-983-5527",
            "fax_number": "269-983-3610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "804 ELM ST",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490851227",
            "telephone_number": "269-983-5527",
            "fax_number": "269-983-3610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUDAK CHIROPRACTIC CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-09",
        "last_updated": "2007-07-23",
        "status": "A",
        "authorized_official_last_name": "HUDAK",
        "authorized_official_first_name": "ERIK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-983-5527",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Joseph, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.