Individual provider Active NPI

Micheal Gregory Medlin, D.C.

  • Chiropractor
  • New Albany, MS
National Provider Identifier
1366496127
Registry record updated Sep 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
0882 Issued in MS
Practice address
132 W Bankhead St Ste B
New Albany, MS 38652-3330
Phone
(662) 534-6636
Fax
(662) 534-6639
NPI assigned
May 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301006169 MI
Chiropractor 111N00000X 0882 MS Primary

Addresses

Primary practice location

132 W Bankhead St Ste B
New Albany, MS 38652-3330

Mailing address

132 W Bankhead St Ste B
New Albany, MS 38652-3330
Phone (662) 534-6636

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120417000634 MS Practitioner - Chiropractic 0547222416 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

132 W Bankhead St
Suite B
New Albany, MS 38652-3315

132 W Bankhead St
Suite B
New Albany, MS 38652-3330
Phone (662) 534-6636

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0882MSMDProfessional Counselor
2301006169MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
M. Greg Medlin, PLC Chiropractor CurrentSince Mar 23, 2006 Accepting new patients
M Greg Medlin, PLLC Chiropractor CurrentSince Feb 27, 2012 Accepting new patients
Quest Health Systems X PLLC Chiropractor Past Accepting new patients
Quest Health Systems VIII, PLLC Chiropractor Past Accepting new patients
Washington Family Chiropractic Center PC Chiropractor Past Accepting new patients

Locations

5909 John R Rd
Troy, MI 48085
Phone (248) 330-0457

132 W Bankhead St
Ste B
New Albany, MS 38652
Phone (662) 534-6636

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410393600000",
    "number": "1366496127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 W BANKHEAD ST STE B",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523330",
            "telephone_number": "662-534-6636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 W BANKHEAD ST STE B",
            "city": "NEW ALBANY",
            "state": "MS",
            "postal_code": "386523330",
            "telephone_number": "662-534-6636",
            "fax_number": "662-534-6639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDLIN",
        "first_name": "MICHEAL",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-19",
        "last_updated": "2014-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006169",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MS",
            "license": "0882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Albany, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.