Individual provider Active NPI

David Max Dutton, DC

  • Chiropractor
  • La Junta, CO
National Provider Identifier
1356560619
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1165 Issued in CO
Practice address
2216 San Juan Ave
La Junta, CO 81050-3324
Phone
(719) 384-7346
Fax
(719) 384-2259
NPI assigned
Apr 25, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1165 CO Primary

Addresses

Primary practice location

2216 San Juan Ave
La Junta, CO 81050-3324

Mailing address

2216 San Juan Ave
La Junta, CO 81050-3324
Phone (719) 384-7346

Other identifiers 1

IdentifierTypeStateIssuer
K3503OtherMEDICARE CORP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1165COMDAudiologist-Hearing Aid Fitter

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1356560619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2216 SAN JUAN AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810503324",
            "telephone_number": "719-384-7346",
            "fax_number": "719-384-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 SAN JUAN AVE",
            "city": "LA JUNTA",
            "state": "CO",
            "postal_code": "810503324",
            "telephone_number": "719-384-7346",
            "fax_number": "719-384-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTTON",
        "first_name": "DAVID",
        "middle_name": "MAX",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "1165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE CORP",
            "identifier": "K3503",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Junta, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.