Nicholas Layne Mullanix, D.C.

Individual provider Active NPI Chiropractor · Creighton, NE

NPI 1528297553 · NPPES record last updated Mar 31, 2016

Key facts

NPI
1528297553
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
1575 (NE)
Practice address
807 Main St
Creighton, NE 68729-4003
Phone
(402) 358-3256
Fax
(402) 358-3256
NPI assigned
Jul 12, 2009
Sex
Male
Sole proprietor
Yes

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.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

807 Main St
Creighton, NE 68729-4003
Phone (402) 358-3256

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NE

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20090811000425 NE Practitioner - Chiropractic 8820142896 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
1575NEMDMassage Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1575 NE Yes

Addresses

Primary practice location

807 Main St
Creighton, NE 68729-4003

Mailing address

807 Main St
P.O. Box 162
Creighton, NE 68729-4003
Phone (402) 358-3256

Other providers in Creighton, NE

All providers in Creighton, NE · Chiropractor in Nebraska

Sources for this page

Verify at the official NPI Registry.