Individual provider Active NPI

Mitchel Stammen, DC

  • Chiropractor
  • Shelbyville, IN
National Provider Identifier
1568176170
Registry record updated Jun 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003355A Issued in IN
Practice address
302 Duran Dr
Shelbyville, IN 46176-1986
Phone
(317) 699-6139
Fax
(317) 699-6154
NPI assigned
Jan 9, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003355A IN Primary

Addresses

Primary practice location

302 Duran Dr
Shelbyville, IN 46176-1986

Mailing address

609 N Charles St
Portland, IN 47371-3011
Phone (260) 726-3065

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231111000157 IN Practitioner - Chiropractic 9133573991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

302 Duran Dr
Shelbyville, IN 46176-1986
Phone (317) 699-6139

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08003355AINMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Clear Chiropractic Shelbyville LLC Chiropractor CurrentSince Nov 1, 2023 Accepting new patients
Major Hospital Past Accepting new patients

Locations

609 N Charles St
Portland, IN 47371
Phone (260) 726-3065

502 Saraina Rd
Shelbyville, IN 46176
Phone (317) 669-6139

302 Duran Dr
Shelbyville, IN 46176
Phone (317) 392-6200

Organizations & group practices 2

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": "1673222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1568176170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "609 N CHARLES ST",
            "city": "PORTLAND",
            "state": "IN",
            "postal_code": "473713011",
            "telephone_number": "260-726-3065",
            "fax_number": "260-726-3406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 DURAN DR",
            "city": "SHELBYVILLE",
            "state": "IN",
            "postal_code": "461761986",
            "telephone_number": "317-699-6139",
            "fax_number": "317-699-6154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAMMEN",
        "first_name": "MITCHEL",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-01-09",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003355A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; 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.