Bruce Douglas Mikota, DC CCSP

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

697 Issued in SC

Practice address

111 West Rutledge Avenue
Gaffney, SC 29340

Phone

(864) 489-2444

Fax

(864) 489-6948

NPI assigned

Jun 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Specialty

Chiropractic

Education

Other, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Bruce D. Mikota,D.C.,P.a.

  • Sports Physician Chiropractor
  • Gaffney, SC
  • NPI 1114133931
  Medicare reassignment NPD Authorized official
• Gaffney Spine & Health Inc

  • Chiropractor
  • Gaffney, SC
  • NPI 1679417810
  NPD

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

{
    "created_epoch": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1831126606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1825",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "29342",
            "telephone_number": "854-489-2444",
            "fax_number": "864-489-6948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WEST RUTLEDGE AVENUE",
            "city": "GAFFNEY",
            "state": "SC",
            "postal_code": "29340",
            "telephone_number": "864-489-2444",
            "fax_number": "864-489-6948"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKOTA",
        "first_name": "BRUCE",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "DC CCSP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "SC",
            "license": "697",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "799",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CHO697",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly B Meissner
• Kirstie Nicole Mensen
• Mentalyst Solutions, LLC
• John Michaels Jr., PTA
• Michelle D. Bedell, D.M.D., P.C.
• Gary W Moneypenny, LMFT
• Ann Marie Montgomery, RN
• Celita Audrett Moore, PHARM.D.
• Donald T Morgan, MD
• Leslie Anne Morgan

• Chiropractor in Gaffney, SC
• Providers in Gaffney, SC by specialty
• Chiropractor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.