NPIMap

Individual provider Active NPI

Mitchell Merriam, DC

  • Chiropractor
  • Downingtown, PA
National Provider Identifier
1467480178
Registry record updated Nov 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC2575L Issued in PA
Practice address
297 W Uwchlan Ave
Downingtown, PA 19335-3361
Phone
(610) 873-2100
Fax
(610) 873-2505
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC2575L PA Primary
Sports Physician Chiropractor 111NS0005X DC2575L PA

Addresses

Primary practice location

297 W Uwchlan Ave
Downingtown, PA 19335-3361

Mailing address

297 W Uwchlan Ave
Downingtown, PA 19335-3361
Phone (610) 873-2100

Other identifiers 3

IdentifierTypeStateIssuer
3656564OtherPAAETNA
0129330000OtherPAKEYSTONE
086717OtherPABLUE CROSS

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

LicenseStateTypeSpecialty
DC2575LPAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Arts & Rehab Therapeutics Chiropractor PastSince Sep 1, 1983 Accepting new patients
Chiropractic Arts Center, LLC Chiropractor PastSince Aug 1, 1996 Accepting new patients
Chiropractic Arts Center, LLC Chiropractor Past Accepting new patients

Organizations & group practices 3

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": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1467480178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 W UWCHLAN AVE",
            "city": "DOWNINGTOWN",
            "state": "PA",
            "postal_code": "193353361",
            "telephone_number": "610-873-2100",
            "fax_number": "610-873-2505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 W UWCHLAN AVE",
            "city": "DOWNINGTOWN",
            "state": "PA",
            "postal_code": "193353361",
            "telephone_number": "610-873-2100",
            "fax_number": "610-873-2505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MERRIAM",
        "first_name": "MITCHELL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC2575L",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "PA",
            "license": "DC2575L",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3656564",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "0129330000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "086717",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Downingtown, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.