Dr. Mike's Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

38MC00587200 Issued in NJ

Legal business name

DR. MIKE'S CHIROPRACTIC LLC

Doing business as

Discover Chiropractic

Practice address

69 S. Black Horse Pike
Blackwood, NJ 08012

Phone

(856) 401-0102

Fax

(856) 374-2345

NPI assigned

Oct 18, 2006

Organization subpart

No

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

Authorized official

Name

Michael Paul Grodzielanek, D.C.NPI 1124061122

Title

Chiropractor/Partner

Phone

(856) 401-0102

Specialties & licenses 1

Addresses

Other names 1

• Discover Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michael Paul Grodzielanek, D.C.

  • Chiropractor
  • Blackwood, NJ
  • NPI 1124061122
  Medicare reassignment Care Compare group NPD Authorized official
• Sandi Doe, D.C.

  • Chiropractor
  • Blackwood, NJ
  • NPI 1740213388
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352246400000",
    "number": "1750462263",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 S. BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-401-0102",
            "fax_number": "856-374-2345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 S. BLACK HORSE PIKE",
            "city": "BLACKWOOD",
            "state": "NJ",
            "postal_code": "08012",
            "telephone_number": "856-401-0102",
            "fax_number": "856-374-2345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MIKE'S CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2012-11-07",
        "status": "A",
        "authorized_official_last_name": "GRODZIELANEK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "CHIROPRACTOR/PARTNER",
        "authorized_official_telephone_number": "856-401-0102",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NJ",
            "license": "38MC00587200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Discover Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Blackwood, NJ
• Providers in Blackwood, NJ by specialty
• Chiropractor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.