Community Chiropractic Spine Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08002577A Issued in IN

Legal business name

COMMUNITY CHIROPRACTIC SPINE CENTER

Practice address

6325 Central Avenue
Portage, IN 46368-3801

Phone

(219) 763-7970

Fax

(219) 762-5338

NPI assigned

Aug 29, 2012

Organization subpart

No

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

Authorized official

Name

Jaclyn Stitt, D.C.NPI 1891076881

Title

President

Phone

(219) 763-7970

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jaclyn Renee Stitt, D.C.

  • Chiropractor
  • Merrillville, IN
  • NPI 1891076881
  Medicare reassignment NPD Authorized official
• David John Cryderman, D.C.

  • Chiropractor
  • Portage, IN
  • NPI 1871502419
  NPD (past)

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1245588847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6325 CENTRAL AVENUE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683801",
            "telephone_number": "219-763-7970",
            "fax_number": "219-762-5338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6325 CENTRAL AVENUE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463683801",
            "telephone_number": "219-763-7970",
            "fax_number": "219-762-5338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CHIROPRACTIC SPINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "STITT",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "219-763-7970",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002577A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer E Cobb, PTA
• Samantha Cochran, ATC, LAT
• Rebecca Colbert
• Abby Collyard
• Hallee Combs
• Community Chiropractic-Portage, P.C.
• Compassion in Homecare LLC
• Christina Connelly, FNP-C
• Terria Conwell
• Kylee Cook

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.