Atherton Back & Neck Care Center

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC005374L Issued in PA

Legal business name

ATHERTON BACK & NECK CARE CENTER

Practice address

1343 N Atherton St
State College, PA 16803-2932

Phone

(814) 234-6699

Fax

(814) 234-6899

NPI assigned

Jul 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. David John Mikula, D.C.NPI 1215959374

Title

President/Owner

Phone

(814) 234-6699

Specialties & licenses 1

Addresses

Other identifiers 4

Other names 1

• Mikula Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in PA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• David John Mikula, D.C.

  • Chiropractor
  • State College, PA
  • NPI 1215959374
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528087533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1343 N ATHERTON ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032932",
            "telephone_number": "814-234-6699",
            "fax_number": "814-234-6899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1343 N ATHERTON ST",
            "city": "STATE COLLEGE",
            "state": "PA",
            "postal_code": "168032932",
            "telephone_number": "814-234-6699",
            "fax_number": "814-234-6899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATHERTON BACK & NECK CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIKULA",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "814-234-6699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC005374L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "MI1346487",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGHMARK",
            "identifier": "MI20627",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE",
            "identifier": "993588",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPITAL BLUE CROSS",
            "identifier": "03087900",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mikula Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• All providers in State College, PA
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.