Organization Active NPI

White Chiropractic Inc.

Doing business as 180 Chiropractic

  • Chiropractor
  • Redlands, CA
National Provider Identifier
1316233802
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
31680 Issued in CA
Legal business name
WHITE CHIROPRACTIC INC.
Doing business as
180 Chiropractic
Practice address
1150 Brookside Ave
Suite J5
Redlands, CA 92373-6300
Phone
(909) 793-5226
Fax
(909) 793-2787
NPI assigned
Jun 22, 2011
Last updated
Jun 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Dr. Micah Ryan White, D.C.NPI 1548562762
Title
Ceo/President
Phone
(909) 793-5226

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 31680 CA Primary

Addresses

Primary practice location

1150 Brookside Ave
Suite J5
Redlands, CA 92373-6300

Mailing address

1150 Brookside Ave
Suite J5
Redlands, CA 92373-6300
Phone (909) 793-5226

Other names 1

  • 180 Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20111005000345 CA Part B Supplier - Clinic/Group Practice 6204008790 Receives reassigned benefits from 1 practitioner
Practice locations: Redlands, CA

National Provider Directory

National Provider Directory

Locations

1150 Brookside Ave
Ste J5
Redlands, CA 92373
Phone (909) 793-5226

Practitioners & affiliated clinicians

Practitioners 4

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": "1308700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1316233802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 BROOKSIDE AVE",
            "address_2": "SUITE J5",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736300",
            "telephone_number": "909-793-5226",
            "fax_number": "909-793-2787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 BROOKSIDE AVE",
            "address_2": "SUITE J5",
            "city": "REDLANDS",
            "state": "CA",
            "postal_code": "923736300",
            "telephone_number": "909-793-5226",
            "fax_number": "909-793-2787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WHITE CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-22",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "MICAH",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "909-793-5226",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31680",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "180 Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Redlands, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 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.