NPIMap

Organization Active NPI

Spine and Joint Associates of Mishawaka, Inc

  • Chiropractor
  • Mishawaka, IN
National Provider Identifier
1609264795
Registry record updated Mar 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001788A Issued in IN
Legal business name
SPINE AND JOINT ASSOCIATES OF MISHAWAKA, INC
Practice address
229 Red Coach Trail
Suite 106
Mishawaka, IN 46545
Phone
(574) 386-2451
NPI assigned
Dec 26, 2014
Last updated
Mar 17, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2015

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

Authorized official

Name
Mrs. Carrie Ann Pinto
Title
President
Phone
(574) 386-2451

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08001788A IN Primary

Addresses

Primary practice location

229 Red Coach Trail
Suite 106
Mishawaka, IN 46545

Mailing address

229 Red Coach Trail
Suite 106
Mishawaka, IN 46545
Phone (574) 386-2451

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150323002191 IN Part B Supplier - Clinic/Group Practice 2163749524 Receives reassigned benefits from 3 practitioners
Practice locations: Mishawaka, IN

National Provider Directory

National Provider Directory

Locations

229 Red Coach Dr
Mishawaka, IN 46545
Phone (574) 252-7795

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1419552000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426550400000",
    "number": "1609264795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "229 RED COACH TRAIL",
            "address_2": "SUITE 106",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-386-2451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "229 RED COACH TRAIL",
            "address_2": "SUITE 106",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "46545",
            "telephone_number": "574-386-2451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE AND JOINT ASSOCIATES OF MISHAWAKA, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-26",
        "last_updated": "2015-03-17",
        "status": "A",
        "authorized_official_last_name": "PINTO",
        "authorized_official_first_name": "CARRIE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "574-386-2451",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001788A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mishawaka, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2015; 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.