Organization Active NPI

Sunderland Chiropractic L.L.C

  • Chiropractor
  • Minden, LA
National Provider Identifier
1316106552
Registry record updated Mar 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1433 Issued in LA
Legal business name
SUNDERLAND CHIROPRACTIC L.L.C
Practice address
100 Angela LN
Minden, LA 71055-3769
Phone
(318) 371-9979
Fax
(318) 371-9949
NPI assigned
Jun 3, 2008
Last updated
Mar 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2010

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

Authorized official

Name
Dr. Jason Matthew Sunderland, D.C.NPI 1548429772
Title
Owner/Operator
Phone
(318) 371-9979

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1433 LA Primary

Addresses

Primary practice location

100 Angela LN
Minden, LA 71055-3769

Mailing address

100 Angela LN
Minden, LA 71055-3769
Phone (318) 371-9979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110121000673 LA Part B Supplier - Clinic/Group Practice 9032398185 Receives reassigned benefits from 1 practitioner
Practice locations: Minden, LA

National Provider Directory

National Provider Directory

Locations

100 Angela Ln
Minden, LA 71055
Phone (318) 371-9979

603 Fleming Ln
Minden, LA 71055
Phone (318) 371-9979

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": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1269302400000",
    "number": "1316106552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 ANGELA LN",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710553769",
            "telephone_number": "318-371-9979",
            "fax_number": "318-371-9949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ANGELA LN",
            "city": "MINDEN",
            "state": "LA",
            "postal_code": "710553769",
            "telephone_number": "318-371-9979",
            "fax_number": "318-371-9949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDERLAND CHIROPRACTIC L.L.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2010-03-23",
        "status": "A",
        "authorized_official_last_name": "SUNDERLAND",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "318-371-9979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Minden, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2010; 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.