Individual provider Active NPI

Andrew Conan Miner, DC

  • Chiropractor
  • Brunswick, ME
National Provider Identifier
1780915405
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR1990 Issued in ME
Practice address
9 Pleasant St
Brunswick, ME 04011-2247
Phone
(207) 725-7177
Fax
(207) 725-5600
NPI assigned
Jan 20, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 70011814 NY
Chiropractor 111N00000X CR1990 ME Primary

Addresses

Primary practice location

9 Pleasant St
Brunswick, ME 04011-2247

Mailing address

9 Pleasant St
Brunswick, ME 04011-2247
Phone (207) 725-7177

Other identifiers 4

IdentifierTypeStateIssuer
1780915405MedicaidME
12060034OtherCAQH NUMBER
CR1990OtherMEMAINE LICENSE
70011814OtherNYNY STATE LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
70011814NYMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Andre Nadeau Chiropractic P.C. Chiropractor PastSince Oct 20, 2014 Accepting new patients
Central Texas ENT, LLP Past Accepting new patients
Miner Adjustments Family Chiropractic P.C. Chiropractor PastSince Feb 12, 2010 Accepting new patients

Organizations & group practices 3

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": "1263945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1780915405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 PLEASANT ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112247",
            "telephone_number": "207-725-7177",
            "fax_number": "207-725-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 PLEASANT ST",
            "city": "BRUNSWICK",
            "state": "ME",
            "postal_code": "040112247",
            "telephone_number": "207-725-7177",
            "fax_number": "207-725-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINER",
        "first_name": "ANDREW",
        "middle_name": "CONAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-20",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "70011814",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR1990",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780915405",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "12060034",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAINE LICENSE",
            "identifier": "CR1990",
            "state": "ME"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NY STATE LICENSE NUMBER",
            "identifier": "70011814",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.