Individual provider Active NPI

Michael Dean Hummer, DC

  • Chiropractor
  • Mishawaka, IN
National Provider Identifier
1700519949
Registry record updated Jul 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08003319A Issued in IN
Practice address
16089 Jackson Rd
Mishawaka, IN 46544-9343
Phone
(574) 271-1771
NPI assigned
Jul 6, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08003319A IN Primary

Addresses

Primary practice location

16089 Jackson Rd
Mishawaka, IN 46544-9343

Mailing address

106 S Brook Ave
Mishawaka, IN 46544-3354
Phone (574) 323-3271

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220914002482 IN Practitioner - Chiropractic 2365827144 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2022
Medicare assignment
May accept Medicare assignment
Group practices
Michael J Dibley DC PCGroup PAC ID 8224191028, 2 clinicians

Practice addresses (Care Compare)

1709 E Bristol St
Elkhart, IN 46514-6606
Phone (574) 264-9174

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Health, Inc Chiropractor Current Accepting new patients
Michael J. Dibley, D.C., P.C. Chiropractor CurrentSince May 12, 2023 Accepting new patients

Locations

1709 E Bristol St
Elkhart, IN 46514
Phone (574) 264-1471

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": "1657065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657065600000",
    "number": "1700519949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 S BROOK AVE",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465443354",
            "telephone_number": "574-323-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16089 JACKSON RD",
            "city": "MISHAWAKA",
            "state": "IN",
            "postal_code": "465449343",
            "telephone_number": "574-271-1771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMMER",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-06",
        "last_updated": "2022-07-06",
        "certification_date": "2022-07-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003319A",
            "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 Jul 6, 2022; 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.