Individual provider Active NPI

Jeffery Charles Michael, D.C.

  • Chiropractor
  • Berlin, MD
National Provider Identifier
1710171236
Registry record updated Oct 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03542 Issued in MD
Practice address
9956 N Main St
Suite 4
Berlin, MD 21811-1077
Phone
(410) 629-1845
NPI assigned
Aug 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 03542 MD Primary

Addresses

Primary practice location

9956 N Main St
Suite 4
Berlin, MD 21811-1077

Mailing address

9956 N Main St
Suite 4
Berlin, MD 21811-1077
Phone (410) 629-1845

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081007000043 MD Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 3274601042 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Palmer College Chiropractic - Davenport, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Optimal Health Chiropractic P. C.Group PAC ID 2163590936, 4 clinicians

Practice addresses (Care Compare)

9956 N Main St
Suite 4
Berlin, MD 21811-1077
Phone (410) 629-1845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Optimal Health Chiropractic P. C. Chiropractor CurrentSince Jul 3, 2008 Accepting new patients

Locations

9956 N Main St
Unit 4
Berlin, MD 21811
Phone (410) 629-1845

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1380585600000",
    "number": "1710171236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9956 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111077",
            "telephone_number": "410-629-1845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9956 N MAIN ST",
            "address_2": "SUITE 4",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218111077",
            "telephone_number": "410-629-1845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHAEL",
        "first_name": "JEFFERY",
        "middle_name": "CHARLES",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-28",
        "last_updated": "2013-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "03542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berlin, MD

Sources for this page

Verify at the official NPI Registry.