Individual provider Active NPI

Aaron C Dutruch, D.C.

  • Chiropractor
  • Mandeville, LA
National Provider Identifier
1700325305
Registry record updated Feb 15, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1785 Issued in LA
Practice address
1120 N Causeway Blvd
Suite 2
Mandeville, LA 70471-3429
Phone
(985) 674-5855
Fax
(985) 674-5854
NPI assigned
Feb 15, 2017
Last updated
Feb 15, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1785 LA Primary

Addresses

Primary practice location

1120 N Causeway Blvd
Suite 2
Mandeville, LA 70471-3429

Mailing address

1120 N Causeway Blvd
Suite 2
Mandeville, LA 70471-3429
Phone (985) 674-5855

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171122000642 LA Practitioner - Chiropractic 5496012734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1120 N Causeway Blvd
Suite 2
Mandeville, LA 70471-3429
Phone (985) 674-5855

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1785LAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dutruch Chiropractic Chiropractor CurrentSince Aug 5, 2017 Accepting new patients

Locations

1120 N Causeway Blvd
Ste 2
Mandeville, LA 70471
Phone (985) 674-5855

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1487116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487116800000",
    "number": "1700325305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 N CAUSEWAY BLVD",
            "address_2": "SUITE 2",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713429",
            "telephone_number": "985-674-5855",
            "fax_number": "985-674-5854"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 N CAUSEWAY BLVD",
            "address_2": "SUITE 2",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704713429",
            "telephone_number": "985-674-5855",
            "fax_number": "985-674-5854"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUTRUCH",
        "first_name": "AARON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-02-15",
        "last_updated": "2017-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1785",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2017; 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.