Active NPI
Nicholas P Manteris, DC
- Chiropractor
- Broomfield, CO
National Provider Identifier
1457733362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 12783
- Practice address
- 2095 W 6TH Ave Ste 105
Broomfield, CO 80020-1870 - Phone
- (720) 508-3982
- Fax
- (720) 287-1452
- NPI assigned
- Jun 27, 2015
- Sex
- Male
- Sole proprietor
- Yes
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 | 12783 | TX | Primary |
Addresses
Primary practice location
2095 W 6TH Ave Ste 105
Broomfield, CO 80020-1870
Mailing address
2095 W 6TH Ave Ste 105
Broomfield, CO 80020-1870
Phone (720) 508-3982
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 |
|---|---|---|---|
| 12783 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435363200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601251200000",
"number": "1457733362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2095 W 6TH AVE STE 105",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800201870",
"telephone_number": "720-508-3982",
"fax_number": "720-287-1452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2095 W 6TH AVE STE 105",
"city": "BROOMFIELD",
"state": "CO",
"postal_code": "800201870",
"telephone_number": "720-508-3982",
"fax_number": "720-287-1452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANTERIS",
"first_name": "NICHOLAS",
"middle_name": "P",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-06-27",
"last_updated": "2020-09-28",
"certification_date": "2020-08-11",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "12783",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Broomfield, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.