Individual provider Active NPI

Michael Shannon Cobb, D.C.

  • Chiropractor
  • Andalusia, AL
National Provider Identifier
1366655888
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1919 Issued in AL
Practice address
305 S Three Notch St
Andalusia, AL 36420-4427
Phone
(334) 428-2225
Fax
(334) 428-2222
NPI assigned
May 8, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 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 1919 AL Primary

Addresses

Primary practice location

305 S Three Notch St
Andalusia, AL 36420-4427

Mailing address

PO Box 42
Andalusia, AL 36420-1200
Phone (334) 428-2225

Other identifiers 1

IdentifierTypeStateIssuer
51003674OtherALBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080918000381 AL Practitioner - Chiropractic 7315014289 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

512 S Three Notch St
Adalusia, AL 36420-4409

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1919ALMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Covington Spine Center, Inc. Chiropractor CurrentSince Jan 1, 2007 Accepting new patients

Locations

305 S Three Notch St
Andalusia, AL 36420
Phone (334) 428-2225

512 S Three Notch St
Andalusia, AL 36420
Phone (334) 428-2225

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": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1366655888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 42",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364201200",
            "telephone_number": "334-428-2225",
            "fax_number": "334-428-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S THREE NOTCH ST",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "364204427",
            "telephone_number": "334-428-2225",
            "fax_number": "334-428-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "MICHAEL",
        "middle_name": "SHANNON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AL",
            "license": "1919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51003674",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Andalusia, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.