Goble Heal Chiropractic PC
Organization Active NPI Chiropractor · Winamac, IN
NPI 1649288689 · NPPES record last updated Apr 9, 2015
Key facts
- NPI
- 1649288689
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 08001280A
- Legal business name
- GOBLE HEAL CHIROPRACTIC PC
- Practice address
- 116 E Pearl Street
Winamac, IN 46996 - Phone
- (574) 946-4113
- Fax
- (574) 946-4552
- NPI assigned
- Aug 4, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Mark A Heal, DC
- Title
- Ceo
- Phone
- (574) 946-4113
Practitioners 7
-
Stephanie Depoy, DC
-
Cheryl E Goble, D.C.
-
Mark A Heal, DC
-
Kevin Day, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050222000933 | IN | Part B Supplier - Clinic/Group Practice | 4789637497 |
Receives reassigned benefits from 6 practitioners Practice locations: Lafayette, IN; Winamac, IN; Rochester, IN |
National Provider Directory
Locations
132 W Main St
Camden, IN 46917
Phone (574) 686-2022
12 Elston Rd
Lafayette, IN 47909
Phone (765) 477-7707
800 Main St
Rochester, IN 46975
Phone (574) 223-5557
1206 S Monticello St
Winamac, IN 46996
Phone (574) 946-4113
116 E Pearl St
Winamac, IN 46996
Phone (574) 946-4113
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 08000878A | ||
| Chiropractor |
111N00000X | 08001280A | Yes |
Addresses
Primary practice location
116 E Pearl Street
Winamac, IN 46996
Mailing address
PO Box 250
116 E Pearl Street
Winamac, IN 46996
Phone (574) 946-4113
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100075800A | Medicaid | IN |
Other providers in Winamac, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 9, 2015. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.