Michael John Dibley Jr., D.C.,C.C.S.P

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

08000910 Issued in IN

Practice address

1709 E Bristol St
Elkhart, IN 46514-6606

Phone

(574) 264-9174

Fax

(574) 262-4070

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1983

Medicare assignment

May accept Medicare assignment

Group practices

Michael J Dibley DC PCGroup PAC ID 8224191028, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Michael J. Dibley, D.C., P.C.

  • Chiropractor
  • Elkhart, IN
  • NPI 1861644676
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245363696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 E. BRISTOL ST.",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465146606",
            "telephone_number": "574-264-9174",
            "fax_number": "574-262-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465146606",
            "telephone_number": "574-264-9174",
            "fax_number": "574-262-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIBLEY",
        "first_name": "MICHAEL",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C.,C.C.S.P",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IN",
            "license": "08000910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaspaul Dhanota, MD
• Chris Dhoore, RPH
• Ruth Diaz-Turcias
• Philip D Dibert, NP
• Andrew Gerard Dibley, D.C.
• Dustin Tyler Diggs, CRNA
• Kristina Lee Dik, OT
• Hannah Dillman
• Kelsey Ellen Dimarzio
• Patricia Rose Dimarzio

• Sports Physician Chiropractor in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Sports Physician Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.