NPIMap

Organization Active NPI

Rushin Chiropractic PC

Doing business as Rushin Chiropractic Center

  • Chiropractor
  • Poplar Bluff, MO
National Provider Identifier
1366610818
Registry record updated Feb 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
004561 Issued in MO
Legal business name
RUSHIN CHIROPRACTIC PC
Doing business as
Rushin Chiropractic Center
Practice address
400 S 11TH St
Poplar Bluff, MO 63901-5508
Phone
(573) 785-5566
NPI assigned
Feb 19, 2008
Last updated
Feb 20, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2008

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

Authorized official

Name
Dr. Jack D Rushin, DCNPI 1093899940
Title
President
Phone
(573) 785-5666

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
Chiropractor 111N00000X 004561 MO Primary

Addresses

Primary practice location

400 S 11TH St
Poplar Bluff, MO 63901-5508

Mailing address

PO Box 1024
400 S. 11TH Street
Poplar Bluff, MO 63902-1024
Phone (573) 785-5666

Other identifiers 2

IdentifierTypeStateIssuer
02895OtherMOUPIN
752079806MedicaidMO

Other names 1

  • Rushin Chiropractic Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041230000087 MO Part B Supplier - Clinic/Group Practice 0941268411 Receives reassigned benefits from 1 practitioner
Practice locations: Poplar Bluff, MO

National Provider Directory

National Provider Directory

Locations

400 S 11th St
Poplar Bluff, MO 63901
Phone (573) 785-5566

Practitioners & affiliated clinicians

Practitioners 3

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": "1203379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1203465600000",
    "number": "1366610818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1024",
            "address_2": "400 S. 11TH STREET",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639021024",
            "telephone_number": "573-785-5666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 S 11TH ST",
            "city": "POPLAR BLUFF",
            "state": "MO",
            "postal_code": "639015508",
            "telephone_number": "573-785-5566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSHIN CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-20",
        "status": "A",
        "authorized_official_last_name": "RUSHIN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "573-785-5666",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "004561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UPIN",
            "identifier": "02895",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "752079806",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rushin Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Poplar Bluff, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.