Individual provider Active NPI

Seth Evan Labott, D.C.

  • Chiropractor
  • Mill Valley, CA
National Provider Identifier
1669594768
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC 27249 Issued in CA
Practice address
465 Miller Ave
Mill Valley, CA 94941-2941
Phone
(415) 389-1098
Fax
(415) 389-1097
NPI assigned
Apr 6, 2007
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 27249 CA Primary

Addresses

Primary practice location

465 Miller Ave
Mill Valley, CA 94941-2941

Mailing address

5 Plaza Dr
Mill Valley, CA 94941-1539
Phone (415) 888-3629

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110811000353 CA Practitioner - Chiropractic 5991789612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

465 Miller Ave
Mill Valley, CA 94941-2941
Phone (415) 389-1098

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC 27249CAMDChiropractor
27249CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Joshua Deitch Chiropractic, Inc CurrentSince Nov 22, 2016 Accepting new patients
Health-Link Medical Center CurrentSince Nov 22, 2016 Accepting new patients

Locations

465 Miller Ave
Mill Valley, CA 94941
Phone (415) 389-1098

Organizations & group practices 2

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": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1669594768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 PLAZA DR",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949411539",
            "telephone_number": "415-888-3629",
            "fax_number": "415-389-1097"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 MILLER AVE",
            "city": "MILL VALLEY",
            "state": "CA",
            "postal_code": "949412941",
            "telephone_number": "415-389-1098",
            "fax_number": "415-389-1097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LABOTT",
        "first_name": "SETH",
        "middle_name": "EVAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 27249",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mill Valley, CA

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.