Organization Active NPI

Back to Health Chiropractic PC

  • Chiropractor
  • Sanford, ME
National Provider Identifier
1811038979
Registry record updated Jan 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR1383 Issued in ME
Legal business name
BACK TO HEALTH CHIROPRACTIC PC
Practice address
15 Daigle LN
Suite 101
Sanford, ME 04073-4173
Phone
(207) 324-7098
Fax
(207) 324-7098
NPI assigned
Feb 10, 2007
Last updated
Jan 13, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2011

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

Authorized official

Name
Dr. Marc Dupuis, D.C.NPI 1669561544
Title
Owner
Phone
(207) 324-7098

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CR1383 ME Primary

Addresses

Primary practice location

15 Daigle LN
Suite 101
Sanford, ME 04073-4173

Mailing address

15 Daigle LN
Suite 101
Sanford, ME 04073-4173
Phone (207) 324-7098

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110801000222 ME Part B Supplier - Clinic/Group Practice 3375711765 Receives reassigned benefits from 3 practitioners
Practice locations: Sanford, ME

National Provider Directory

National Provider Directory

Locations

15 Daigle Ln
#101
Sanford, ME 04073
Phone (207) 324-3745

21 Daigle Ln
Ste 103
Sanford, ME 04073
Phone (207) 324-7098

Practitioners & affiliated clinicians

Practitioners 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1294876800000",
    "number": "1811038979",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 DAIGLE LN",
            "address_2": "SUITE 101",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040734173",
            "telephone_number": "207-324-7098",
            "fax_number": "207-324-7098"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 DAIGLE LN",
            "address_2": "SUITE 101",
            "city": "SANFORD",
            "state": "ME",
            "postal_code": "040734173",
            "telephone_number": "207-324-7098",
            "fax_number": "207-324-7098"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK TO HEALTH CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-10",
        "last_updated": "2011-01-13",
        "status": "A",
        "authorized_official_last_name": "DUPUIS",
        "authorized_official_first_name": "MARC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "207-324-7098",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ME",
            "license": "CR1383",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sanford, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2011; 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.