Individual provider Active NPI

Michael Barry Seidman, D.C.

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1285632588
Registry record updated Jun 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1946012 Issued in WI
Practice address
741 Brady St
Palmer Chiropractic College
Davenport, IA 52803-5209
Phone
(414) 884-5303
Fax
(563) 884-5227
NPI assigned
Jul 11, 2005
Last updated
Jun 30, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1946012 WI Primary

Addresses

Primary practice location

741 Brady St
Palmer Chiropractic College
Davenport, IA 52803-5209

Mailing address

741 Brady St.
Palmer Center for Chiropractic Research
Davenport, IA 52803-5209
Phone (563) 505-8133

Other identifiers 1

IdentifierTypeStateIssuer
38846000MedicaidWI

Other names 1

  • Dr. Michael Barry Seidman Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1946012WIMDChiropractor
1946WIMDSurgical Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277856000000",
    "number": "1285632588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "741 BRADY ST.",
            "address_2": "PALMER CENTER FOR CHIROPRACTIC RESEARCH",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035209",
            "telephone_number": "563-505-8133",
            "fax_number": "563-884-5227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "741 BRADY ST",
            "address_2": "PALMER CHIROPRACTIC COLLEGE",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035209",
            "telephone_number": "414-884-5303",
            "fax_number": "563-884-5227"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEIDMAN",
        "first_name": "MICHAEL",
        "middle_name": "BARRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2010-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "1946012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38846000",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "SEIDMAN",
            "middle_name": "BARRY",
            "prefix": "DR.",
            "credential": "D.C., M.S.W.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2010; 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.