Organization Active NPI

Monroe County Chiropractic

  • Chiropractor
  • Bloomington, IN
National Provider Identifier
1750575825
Registry record updated Sep 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001673A Issued in IN
Legal business name
MONROE COUNTY CHIROPRACTIC
Practice address
2974 N Lakewood CT
Bloomington, IN 47408-1081
Phone
(812) 339-4430
Fax
(812) 339-4476
NPI assigned
Aug 31, 2007
Last updated
Sep 26, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2008

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

Authorized official

Name
Dr. John Kardynalczyk, D.C.
Title
Chiropractor/Owner
Phone
(812) 339-4430

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 08001673A IN Primary

Addresses

Primary practice location

2974 N Lakewood CT
Bloomington, IN 47408-1081

Mailing address

2974 N Lakewood CT
Bloomington, IN 47408-1081
Phone (812) 339-4430

Other identifiers 2

IdentifierTypeStateIssuer
000000186894OtherINANTHEM B/C B/S
200166940AMedicaidIN

National Provider Directory

National Provider Directory

Locations

1040 W 17th St
Bloomington, IN 47404
Phone (812) 339-4430

NPI Registry JSON

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

{
    "created_epoch": "1188518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222387200000",
    "number": "1750575825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2974 N LAKEWOOD CT",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474081081",
            "telephone_number": "812-339-4430",
            "fax_number": "812-339-4476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2974 N LAKEWOOD CT",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474081081",
            "telephone_number": "812-339-4430",
            "fax_number": "812-339-4476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MONROE COUNTY CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-31",
        "last_updated": "2008-09-26",
        "status": "A",
        "authorized_official_last_name": "KARDYNALCZYK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "812-339-4430",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001673A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM B/C B/S",
            "identifier": "000000186894",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200166940A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.