Organization Active NPI

Hulbert Chiropractic PC

  • Nutrition Chiropractor
  • Bloomington, IN
National Provider Identifier
1255571360
Registry record updated Jun 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
08002421A Issued in IN
Legal business name
HULBERT CHIROPRACTIC PC
Practice address
353 S Landmark Ave
Bloomington, IN 47403-5001
Phone
(812) 330-1234
Fax
(812) 330-1221
NPI assigned
Mar 2, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2009

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

Authorized official

Name
Dr. Travis Russell Hulbert, DCNPI 1407093719
Title
Doctor of Chiropractic
Phone
(812) 330-1234

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
Nutrition ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN1001X 08002421A IN Primary

Addresses

Primary practice location

353 S Landmark Ave
Bloomington, IN 47403-5001

Mailing address

353 S Landmark Ave
Bloomington, IN 47403-5001
Phone (812) 330-1234

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090617000451 IN Part B Supplier - Clinic/Group Practice 4284784083 Receives reassigned benefits from 1 practitioner
Practice locations: Bloomington, IN

National Provider Directory

National Provider Directory

Locations

4617 W Richland Plaza Dr
Bloomington, IN 47404
Phone (812) 330-1234

4617 W Richland Plaza Dr
#C
Bloomington, IN 47404
Phone (812) 330-1234

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1235952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245283200000",
    "number": "1255571360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035001",
            "telephone_number": "812-330-1234",
            "fax_number": "812-330-1221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 S LANDMARK AVE",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474035001",
            "telephone_number": "812-330-1234",
            "fax_number": "812-330-1221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HULBERT CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-03-02",
        "last_updated": "2009-06-18",
        "status": "A",
        "authorized_official_last_name": "HULBERT",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "812-330-1234",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "IN",
            "license": "08002421A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2009; 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.