Individual provider Active NPI

Joseph Adam Mullanack

  • Chiropractor
  • Fort Pierce, FL
National Provider Identifier
1508883513
Registry record updated Feb 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH9193 Issued in FL
Practice address
1406 S 25TH St
Fort Pierce, FL 34947-4706
Phone
(772) 464-3831
Fax
(772) 468-8921
NPI assigned
Jul 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH9193 FL Primary

Addresses

Primary practice location

1406 S 25TH St
Fort Pierce, FL 34947-4706

Mailing address

1406 S 25TH St
Fort Pierce, FL 34947-4706
Phone (772) 584-0793

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070326000060 FL Practitioner - Chiropractic 9931203387 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1406 S 25TH St
Fort Pierce, FL 34947-4706
Phone (772) 464-3831

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph a Mullanack DC PA Chiropractor CurrentSince Oct 11, 2007 Accepting new patients

Locations

1406 S 25th St
Fort Pierce, FL 34947
Phone (772) 464-3831

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": "1153008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1508883513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474706",
            "telephone_number": "772-584-0793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 S 25TH ST",
            "city": "FORT PIERCE",
            "state": "FL",
            "postal_code": "349474706",
            "telephone_number": "772-464-3831",
            "fax_number": "772-468-8921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLANACK",
        "first_name": "JOSEPH",
        "middle_name": "ADAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-16",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH9193",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Pierce, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2018; 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.