Organization Active NPI

Smith Family Chiropractic,LLC

  • Chiropractor
  • Canonsburg, PA
National Provider Identifier
1528108537
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC007640L Issued in PA
Legal business name
SMITH FAMILY CHIROPRACTIC,LLC
Practice address
26 N Central Ave
Canonsburg, PA 15317-1302
Phone
(724) 743-4949
Fax
(724) 743-4767
NPI assigned
Feb 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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

Authorized official

Name
Dr. Michael Jon Smith, DCNPI 1649367608
Title
Chiropractor
Phone
(724) 743-4949

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC007640L PA Primary

Addresses

Primary practice location

26 N Central Ave
Canonsburg, PA 15317-1302

Mailing address

26 N Central Ave
Canonsburg, PA 15317-1302
Phone (724) 743-4949

Other identifiers 1

IdentifierTypeStateIssuer
1431628OtherBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080312000278 PA Part B Supplier - Clinic/Group Practice 0244315422 Receives reassigned benefits from 1 practitioner
Practice locations: Canonsburg, PA

National Provider Directory

National Provider Directory

Locations

26 N Central Ave
Canonsburg, PA 15317
Phone (724) 743-4949

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205193600000",
    "number": "1528108537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 N CENTRAL AVE",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153171302",
            "telephone_number": "724-743-4949",
            "fax_number": "724-743-4767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 N CENTRAL AVE",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153171302",
            "telephone_number": "724-743-4949",
            "fax_number": "724-743-4767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMITH FAMILY CHIROPRACTIC,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2008-03-11",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JON",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "724-743-4949",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC007640L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1431628",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; 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.