Eric N Stulc, D.C.
Individual provider Active NPI Chiropractor · Laporte, IN
NPI 1447288154 · NPPES record last updated May 6, 2009
Key facts
- NPI
- 1447288154
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08001662A (IN)
- Practice address
- 602 'I' Street
Laporte, IN 46350 - Phone
- (219) 325-0441
- Fax
- (219) 325-0549
- NPI assigned
- Jun 29, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Northwestern College of Chiropractic, 1995
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
602 I St
La Porte, IN 46350-5530
Phone (219) 325-0441
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090518000543 | IN | Practitioner - Chiropractic | 6103975396 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08001662 | IN | MD | Chiropractor |
| 08001662A | IN | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Laporte Chiropractic Clinic Inc. | Current |
Accepting new patients |
Locations
323 J St
Laporte, IN 46350
Phone (219) 325-0441
602 I St
Laporte, IN 46350
Phone (219) 325-0441
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08001662 | IN | |
| Chiropractor | 111N00000X | 08001662A | IN | Yes |
Addresses
Primary practice location
602 'I' Street
Laporte, IN 46350
Mailing address
602 'I' Street
Laporte, IN 46350
Phone (219) 325-0441
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 200113870A | Medicaid | IN | |
| 200113870 | Medicaid | IN |
Other providers in Laporte, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 6, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.