Organization Active NPI

Summit Chiropractic and Wellness Center PC

  • Chiropractor
  • Flagstaff, AZ
National Provider Identifier
1609084128
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7149 Issued in AZ
Legal business name
SUMMIT CHIROPRACTIC AND WELLNESS CENTER PC
Practice address
2615 N 4TH St
Suite 3
Flagstaff, AZ 86004-1812
Phone
(928) 214-8969
Fax
(928) 214-7405
NPI assigned
May 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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

Authorized official

Name
Dr. Michael S Martin
Title
Chiropractor
Phone
(928) 214-8969

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 7149 AZ Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 3836 AZ

Addresses

Primary practice location

2615 N 4TH St
Suite 3
Flagstaff, AZ 86004-1812

Mailing address

2615 N 4TH St
Suite 3
Flagstaff, AZ 86004-1812
Phone (928) 214-8969

National Provider Directory

National Provider Directory

Locations

2615 N 4th St
Ste 3
Flagstaff, AZ 86004
Phone (928) 214-8969

2717 N 4th St
Ste 100
Flagstaff, AZ 86004
Phone (928) 774-1463

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453161600000",
    "number": "1609084128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 N 4TH ST",
            "address_2": "SUITE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041812",
            "telephone_number": "928-214-8969",
            "fax_number": "928-214-7405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 N 4TH ST",
            "address_2": "SUITE 3",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860041812",
            "telephone_number": "928-214-8969",
            "fax_number": "928-214-7405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CHIROPRACTIC AND WELLNESS CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2016-01-19",
        "status": "A",
        "authorized_official_last_name": "MARTIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "928-214-8969",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7149",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "3836",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.