Active NPI
Steven M Mazur, DC
- Chiropractor
- Missoula, MT
National Provider Identifier
1407913080
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MT615
- Practice address
- 1048 Burlington Ave
Suite 101
Missoula, MT 59801-5683 - Phone
- (406) 549-2771
- Fax
- (406) 926-1227
- NPI assigned
- Jan 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MT615 | MT | Primary |
Addresses
Primary practice location
1048 Burlington Ave
Suite 101
Missoula, MT 59801-5683
Mailing address
PO Box 1176
Lolo, MT 59847-1176
Phone (406) 549-2771
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| U10340 | Other | STERLING | |
| 0000162503 | Medicaid | MT | |
| 040480 | Other | BLUE CROSS BLUE SHIELD MT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT615 | MT | MD | Chiropractor |
| 615 | MT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167696000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492732800000",
"number": "1407913080",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1176",
"city": "LOLO",
"state": "MT",
"postal_code": "598471176",
"telephone_number": "406-549-2771",
"fax_number": "406-549-3925"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1048 BURLINGTON AVE",
"address_2": "SUITE 101",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598015683",
"telephone_number": "406-549-2771",
"fax_number": "406-926-1227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZUR",
"first_name": "STEVEN",
"middle_name": "M",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-01-02",
"last_updated": "2017-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MT",
"license": "MT615",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STERLING",
"identifier": "U10340",
"state": null
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0000162503",
"state": "MT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD MT",
"identifier": "040480",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.