Organization Active NPI

McGovern Family Chiropractic PC

  • Chiropractor
  • Danvers, MA
National Provider Identifier
1295195584
Registry record updated Feb 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3511 Issued in MA
Legal business name
MCGOVERN FAMILY CHIROPRACTIC PC
Practice address
47 Elm St Ste 3
Danvers, MA 01923-2835
Phone
(978) 646-0010
Fax
(978) 646-0076
NPI assigned
Feb 29, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 29, 2016

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

Authorized official

Name
Matthew Michael McGovern, D.C
Title
Owner
Phone
(315) 272-9746

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 3511 MA Primary

Addresses

Primary practice location

47 Elm St Ste 3
Danvers, MA 01923-2835

Mailing address

47 Elm St Ste 3
Danvers, MA 01923-2835
Phone (978) 646-0010

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160318001660 MA Part B Supplier - Clinic/Group Practice 6507163573 Receives reassigned benefits from 1 practitioner
Practice locations: Danvers, MA

National Provider Directory

National Provider Directory

Locations

85 Constitution Ln
Ste 1E
Danvers, MA 01923
Phone (978) 646-0010

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1456704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456704000000",
    "number": "1295195584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 ELM ST STE 3",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232835",
            "telephone_number": "978-646-0010",
            "fax_number": "978-646-0076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 ELM ST STE 3",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019232835",
            "telephone_number": "978-646-0010",
            "fax_number": "978-646-0076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCGOVERN FAMILY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-29",
        "last_updated": "2016-02-29",
        "status": "A",
        "authorized_official_last_name": "MCGOVERN",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "315-272-9746",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MA",
            "license": "3511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2016; 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.