NPIMap

Organization Active NPI

Cerefin Chiropractic Clinic, Inc.

Doing business as Southside Pain Solutions

  • Chiropractor
  • Indianapolis, IN
National Provider Identifier
1386765279
Registry record updated Jun 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001590 Issued in IN
Legal business name
CEREFIN CHIROPRACTIC CLINIC, INC.
Doing business as
Southside Pain Solutions
Practice address
7855 S Emerson Ave
Suite Q
Indianapolis, IN 46237-8668
Phone
(317) 884-2636
Fax
(317) 884-2633
NPI assigned
Apr 2, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2011

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

Authorized official

Name
Dr. Michael T Cerefin, D.C.
Title
President
Phone
(317) 884-2636

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 08001590 IN Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 05007356A IN

Addresses

Primary practice location

7855 S Emerson Ave
Suite Q
Indianapolis, IN 46237-8668

Mailing address

7855 S Emerson Ave
Suite Q
Indianapolis, IN 46237-8668
Phone (317) 884-2636

Other identifiers 1

IdentifierTypeStateIssuer
200027820AMedicaidIN

Other names 1

  • Southside Pain Solutions Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1307318400000",
    "number": "1386765279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7855 S EMERSON AVE",
            "address_2": "SUITE Q",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378668",
            "telephone_number": "317-884-2636",
            "fax_number": "317-884-2633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7855 S EMERSON AVE",
            "address_2": "SUITE Q",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462378668",
            "telephone_number": "317-884-2636",
            "fax_number": "317-884-2633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEREFIN CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2011-06-06",
        "status": "A",
        "authorized_official_last_name": "CEREFIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-884-2636",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001590",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05007356A",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200027820A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Southside Pain Solutions",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Indianapolis, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.