John Samuel Irwin IV, D.C.
Individual provider Active NPI Chiropractor · Clanton, AL
NPI 1598856072 · NPPES record last updated Jul 20, 2012
Key facts
- NPI
- 1598856072
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 1994 (AL)
- Practice address
- 104 Popwell Avenue
Clanton, AL 35045-2324 - Phone
- (205) 755-4430
- Fax
- (205) 755-4472
- NPI assigned
- Sep 27, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2000
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
104 Popwell Ave
Clanton, AL 35045-2324
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080515000549 | AL | Practitioner - Chiropractic | 6103995246 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1994 | AL | MD | Pastoral Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| John S. Irwin, D.C., P.C. | Chiropractor | Current |
Accepting new patients |
Locations
104 Popwell Ave
Clanton, AL 35045
Phone (205) 755-3980
507 2nd Ave S
Clanton, AL 35045
Phone (205) 755-4430
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1994 | AL | Yes |
Addresses
Primary practice location
104 Popwell Avenue
Clanton, AL 35045-2324
Mailing address
104 Popwell Ave
Clanton, AL 35045-2324
Phone (205) 755-4430
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 51553204 | Other | AL | BCBS OF AL PROVIDER ID |
Other providers in Clanton, AL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 20, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.