Organization Active NPI

Auburn Chiropractic Clinic P C

  • Health Service Clinic/Center
  • Auburn, IN
National Provider Identifier
1376962480
Registry record updated Apr 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
License
08001701A Issued in IN
Legal business name
AUBURN CHIROPRACTIC CLINIC P C
Practice address
421 Smith Dr
Auburn, IN 46706-3655
Phone
(260) 925-0357
Fax
(260) 925-6074
NPI assigned
Apr 16, 2014
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Tyler W Chalfant, D.C.NPI 1194764332
Title
Owner
Phone
(260) 925-0357

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140501000313 IN Part B Supplier - Clinic/Group Practice 9133137706 Receives reassigned benefits from 2 practitioners
Practice locations: Auburn, IN

National Provider Directory

National Provider Directory

Locations

421 Smith Dr
Auburn, IN 46706
Phone (260) 908-6623

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X 08001701A IN Primary

Addresses

NPPES NPI Registry

Primary practice location

421 Smith Dr
Auburn, IN 46706-3655

Mailing address

421 Smith Dr
Auburn, IN 46706-3655
Phone (260) 925-0357

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
200828120AMedicaidIN

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Apr 23, 2014.

{
    "created_epoch": "1397606400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1398211200000",
    "number": "1376962480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 SMITH DR",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467063655",
            "telephone_number": "260-925-0357",
            "fax_number": "260-925-6074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "421 SMITH DR",
            "city": "AUBURN",
            "state": "IN",
            "postal_code": "467063655",
            "telephone_number": "260-925-0357",
            "fax_number": "260-925-6074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AUBURN CHIROPRACTIC CLINIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-16",
        "last_updated": "2014-04-23",
        "status": "A",
        "authorized_official_last_name": "CHALFANT",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "260-925-0357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "IN",
            "license": "08001701A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200828120A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2014; 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.