Dewitt Chiropractic, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1145 Issued in MS

Legal business name

DEWITT CHIROPRACTIC, PLLC

Practice address

15465 Oak LN
Suite 100B
Gulfport, MS 39503-2663

Phone

(228) 832-0846

Fax

(228) 832-0856

NPI assigned

Mar 25, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Bradford J Dewitt, D.C.NPI 1013151638

Title

Owner

Phone

(228) 832-0846

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MS

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.

• Bradford Joseph Dewitt, D.C.

  • Chiropractor
  • Gulfport, MS
  • NPI 1013151638
  Medicare reassignment NPD Authorized official
• Joseph A Rogers, DC

  • Chiropractor
  • Gulfport, MS
  • NPI 1669566881
  NPD (past)

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

{
    "created_epoch": "1269475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376352000000",
    "number": "1285958868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15465 OAK LN",
            "address_2": "SUITE 100B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032663",
            "telephone_number": "228-832-0846",
            "fax_number": "228-832-0856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15465 OAK LN",
            "address_2": "SUITE 100B",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395032663",
            "telephone_number": "228-832-0846",
            "fax_number": "228-832-0856"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEWITT CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-25",
        "last_updated": "2013-08-13",
        "status": "A",
        "authorized_official_last_name": "DEWITT",
        "authorized_official_first_name": "BRADFORD",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-832-0846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "1145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTH CARE",
            "identifier": "93014524",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "953596",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "302I354509",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "9194329",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Gulfport, MS
• Providers in Gulfport, MS by specialty
• Chiropractor in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; 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.