Smac Sport & Spine

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

SMAC SPORT & SPINE

Practice address

15851 Campfire PL
Hughesville, MD 20637-2706

Phone

(443) 359-8126

NPI assigned

Nov 22, 2016

Last updated

Sep 10, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas Robert Dimichele, D.C.

Title

Owner

Phone

(443) 359-8126

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1479772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536537600000",
    "number": "1255874327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15851 CAMPFIRE PL",
            "city": "HUGHESVILLE",
            "state": "MD",
            "postal_code": "206372706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15851 CAMPFIRE PL",
            "city": "HUGHESVILLE",
            "state": "MD",
            "postal_code": "206372706",
            "telephone_number": "443-359-8126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMAC SPORT & SPINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-22",
        "last_updated": "2018-09-10",
        "status": "A",
        "authorized_official_last_name": "DIMICHELE",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-359-8126",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.