Organization Active NPI

Spearman Chiropractic Professional Corporation

  • Nutrition Chiropractor
  • Los Angeles, CA
National Provider Identifier
1346406527
Registry record updated Aug 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
DC24621 Issued in CA
Legal business name
SPEARMAN CHIROPRACTIC PROFESSIONAL CORPORATION
Practice address
1279 N Berendo St
Los Angeles, CA 90029-1601
Phone
(323) 663-1066
NPI assigned
Aug 6, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2008

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

Authorized official

Name
Dr. Michael Stewart Spearman, D.C.NPI 1144435223
Title
Chiropractor/Owner
Phone
(323) 663-1066

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
Nutrition ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NN1001X DC24621 CA Primary

Addresses

Primary practice location

1279 N Berendo St
Los Angeles, CA 90029-1601

Mailing address

4610 Nob Hill Dr
Los Angeles, CA 90065-4121
Phone (323) 663-1066

Other identifiers 1

IdentifierTypeStateIssuer
DC24621OtherCAMEDICARE ID (PTAN)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120411000115 CA Part B Supplier - Clinic/Group Practice 4486815933 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Locations

1279 N Berendo St
Los Angeles, CA 90029
Phone (323) 400-6040

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": "1217980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217980800000",
    "number": "1346406527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4610 NOB HILL DR",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900654121",
            "telephone_number": "323-663-1066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 N BERENDO ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900291601",
            "telephone_number": "323-663-1066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPEARMAN CHIROPRACTIC PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-06",
        "last_updated": "2008-08-06",
        "status": "A",
        "authorized_official_last_name": "SPEARMAN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "STEWART",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "323-663-1066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "CA",
            "license": "DC24621",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID (PTAN)",
            "identifier": "DC24621",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2008; 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.