Organization Active NPI

Blum Chiropractic LLC

  • Chiropractor
  • Mishawaka, IN
National Provider Identifier
1235709130
Registry record updated Jan 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BLUM CHIROPRACTIC LLC
Doing business as
Blum Family Chiropractic
Practice address
812 W Edison Rd
Mishawaka, IN 46545-2744
Phone
(574) 276-4492
NPI assigned
Jul 1, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2022

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

Authorized official

Name
Dr. Joseph Blum, DC
Title
Owner
Phone
(574) 276-4492

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

812 W Edison Rd
Mishawaka, IN 46545-2744

Mailing address

54751 Rustic Ter
Mishawaka, IN 46545-1568
Phone (574) 276-4492

Other names 1

  • Blum Family Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220203000211 IN Part B Supplier - Clinic/Group Practice 6204229818 Receives reassigned benefits from 1 practitioner
Practice locations: Mishawaka, IN

National Provider Directory

National Provider Directory

Locations

812 W Edison Rd
Mishawaka, IN 46545
Phone (574) 256-2739

Practitioners & affiliated clinicians

Practitioners 2

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": "1625097600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643241600000",
    "number": "1235709130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54751 RUSTIC TER",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465451568",
            "telephone_number": "574-276-4492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 W EDISON RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465452744",
            "telephone_number": "574-276-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUM CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-01",
        "last_updated": "2022-01-27",
        "certification_date": "2022-01-27",
        "status": "A",
        "authorized_official_last_name": "BLUM",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-276-4492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Blum Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Blum Family Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2022; 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.