Individual provider Active NPI

Mitchell Robert Silverman, D.C.

  • Sports Physician Chiropractor
  • Baltimore, MD
National Provider Identifier
1376665141
Registry record updated Nov 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
SO1450 Issued in MD
Practice address
1703 E Joppa Rd
Baltimore, MD 21234-3638
Phone
(410) 665-6666
Fax
(410) 882-1264
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X SO1450 MD Primary

Addresses

Primary practice location

1703 E Joppa Rd
Baltimore, MD 21234-3638

Mailing address

1703 E Joppa Rd
Baltimore, MD 21234-3638
Phone (410) 665-6666

Other identifiers 2

IdentifierTypeStateIssuer
R420 0001OtherDCCAREFIRST OF DC
K687AGOtherMDCAREFIRST OF MD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120228000385 MD Practitioner - Chiropractic 5193983724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1989
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1703 E Joppa Rd
Baltimore, MD 21234-3638
Phone (410) 665-6666

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SO1450MDMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Head,Neck & Back Pain Center P.a. Sports Physician CurrentSince Oct 1, 1998 Accepting new patients

Locations

1703 E Joppa Rd
Parkville, MD 21234
Phone (410) 665-6666

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196035200000",
    "number": "1376665141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1703 E JOPPA RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212343638",
            "telephone_number": "410-665-6666",
            "fax_number": "410-882-1264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1703 E JOPPA RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212343638",
            "telephone_number": "410-665-6666",
            "fax_number": "410-882-1264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SILVERMAN",
        "first_name": "MITCHELL",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MD",
            "license": "SO1450",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF DC",
            "identifier": "R420 0001",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST OF MD",
            "identifier": "K687AG",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.