NPIMap

Organization Active NPI

Artisan Chiropractic Clinic, LLC

  • Chiropractor
  • Hyattsville, MD
National Provider Identifier
1447716899
Registry record updated May 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ARTISAN CHIROPRACTIC CLINIC, LLC
Practice address
4301 Garden City Dr Ste 205
Hyattsville, MD 20785-2210
Phone
(240) 341-0005
Fax
(240) 341-0004
NPI assigned
Feb 11, 2019
Last updated
May 14, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2024

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

Authorized official

Name
Dr. Yetunde OniNPI 1669825337
Title
Chiropractor
Phone
(240) 462-2945

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

4301 Garden City Dr Ste 205
Hyattsville, MD 20785-2210

Mailing address

4301 Garden City Dr Ste 205
Hyattsville, MD 20785-2210
Phone (240) 341-0005

Other practice location 1

14201 Laurel Park Dr Ste 212
Laurel, MD 20707-5203
Phone (240) 341-0005

Other practice location 2

11750 Business Park Dr Ste 206
Waldorf, MD 20601-2999
Phone (240) 341-0005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200713000054 DC Part B Supplier - Clinic/Group Practice 9537582366 Receives reassigned benefits from 4 practitioners
Practice locations: Hyattsville, MD; Waldorf, MD

National Provider Directory

National Provider Directory
Tax ID family
Artisan Chiropractic Clinic LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

4301 Garden City Dr
Ste 205
Hyattsville, MD 20785
Phone (240) 341-0005

14201 Laurel Park Dr
Ste 212
Laurel, MD 20707
Phone (240) 341-0005

5098 Brown Station Rd
#110
Upper Marlboro, MD 20772

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1549843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1715644800000",
    "number": "1447716899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 GARDEN CITY DR STE 205",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207852210",
            "telephone_number": "240-341-0005",
            "fax_number": "240-341-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 GARDEN CITY DR STE 205",
            "city": "HYATTSVILLE",
            "state": "MD",
            "postal_code": "207852210",
            "telephone_number": "240-341-0005",
            "fax_number": "240-341-0004"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14201 Laurel Park Dr Ste 212",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207075203",
            "country_code": "US",
            "telephone_number": "240-341-0005",
            "fax_number": "240-341-0004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11750 Business Park Dr Ste 206",
            "address_purpose": "LOCATION",
            "city": "Waldorf",
            "state": "MD",
            "postal_code": "206012999",
            "country_code": "US",
            "telephone_number": "240-341-0005",
            "fax_number": "240-341-0004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ARTISAN CHIROPRACTIC CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-11",
        "last_updated": "2024-05-14",
        "certification_date": "2024-05-14",
        "status": "A",
        "authorized_official_last_name": "ONI",
        "authorized_official_first_name": "YETUNDE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "240-462-2945",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hyattsville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2024; 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.