Individual provider Active NPI

Michael Jon Smith, DC

  • Chiropractor
  • Canonsburg, PA
National Provider Identifier
1649367608
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC-007640 Issued in PA
Practice address
26 N Central Ave
Canonsburg, PA 15317-1302
Phone
(724) 743-4949
NPI assigned
Oct 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC-007640 PA Primary

Addresses

Primary practice location

26 N Central Ave
Canonsburg, PA 15317-1302

Mailing address

139 Pearl Dr
Canonsburg, PA 15317-2246
Phone (724) 328-2969

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080312000248 PA Practitioner - Chiropractic 9638254816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

26 N Central Ave
Canonsburg, PA 15317-1302
Phone (724) 743-4949

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC-007640PAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Smith Family Chiropractic,LLC Chiropractor CurrentSince Jan 28, 2008 Accepting new patients
Sala Chiropractic, Inc. Chiropractor PastSince Feb 27, 2019 Accepting new patients
Bethel Park Medical and Wellness Past Accepting new patients

Locations

26 N Central Ave
Canonsburg, PA 15317
Phone (724) 743-4949

Organizations & group practices 3

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": "1160352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649367608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 PEARL DR",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153172246",
            "telephone_number": "724-328-2969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 N CENTRAL AVE",
            "city": "CANONSBURG",
            "state": "PA",
            "postal_code": "153171302",
            "telephone_number": "724-743-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "MICHAEL",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC-007640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canonsburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.