Individual provider Active NPI

Donald D Pattison, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1407919764
Registry record updated Jun 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2011015868 Issued in MO
Practice address
3414 W Union Hills Dr Ste 13
Phoenix, AZ 85027-4899
Phone
(623) 581-0051
Fax
(623) 581-1924
NPI assigned
Dec 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2011015868 MO Primary

Addresses

Primary practice location

3414 W Union Hills Dr Ste 13
Phoenix, AZ 85027-4899

Mailing address

3414 W Union Hills Dr Ste 13
Phoenix, AZ 85027-4899
Phone (623) 581-0051

Other identifiers 1

IdentifierTypeStateIssuer
1407919764OtherMONPI INDIVDUAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200713002565 AZ Practitioner - Chiropractic 5698866218

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1973
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3414 W Union Hills Dr
Suite 13
Phoenix, AZ 85027-4899

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011015868MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
John E. Dugie II, D.C., P.C. Chiropractor Past Accepting new patients

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593388800000",
    "number": "1407919764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3414 W UNION HILLS DR STE 13",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274899",
            "telephone_number": "623-581-0051",
            "fax_number": "623-581-1924"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3414 W UNION HILLS DR STE 13",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850274899",
            "telephone_number": "623-581-0051",
            "fax_number": "623-581-1924"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATTISON",
        "first_name": "DONALD",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-18",
        "last_updated": "2020-06-29",
        "certification_date": "2020-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2011015868",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVDUAL",
            "identifier": "1407919764",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2020; 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.