Organization Active NPI

Dettwiler Chiropractic, L.L.C.

  • Chiropractor
  • Fishers, IN
National Provider Identifier
1548397771
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08002271A Issued in IN
Legal business name
DETTWILER CHIROPRACTIC, L.L.C.
Practice address
9865 E 116TH St
Suite 150
Fishers, IN 46037-9231
Phone
(317) 841-1209
NPI assigned
Feb 27, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jeffrey Daniel Dettwiler, D.C.NPI 1215028592
Title
President
Phone
(317) 902-5802

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
Chiropractor 111N00000X 08002271A IN Primary

Addresses

Primary practice location

9865 E 116TH St
Suite 150
Fishers, IN 46037-9231

Mailing address

11711 Wedgeport LN
Fishers, IN 46037-7985
Phone (317) 902-5802

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070510000345 IN Part B Supplier - Clinic/Group Practice 8527164342 Receives reassigned benefits from 1 practitioner
Practice locations: Fishers, IN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1548397771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11711 WEDGEPORT LN",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460377985",
            "telephone_number": "317-902-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9865 E 116TH ST",
            "address_2": "SUITE 150",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "460379231",
            "telephone_number": "317-841-1209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DETTWILER CHIROPRACTIC, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "DETTWILER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-902-5802",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002271A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

  • 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.