Organization Active NPI

Mesa Family Chiropractic, PC

  • Chiropractor
  • Montrose, CO
National Provider Identifier
1831492693
Registry record updated Dec 15, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6575 Issued in CO
Legal business name
MESA FAMILY CHIROPRACTIC, PC
Practice address
700 E Main St
Montrose, CO 81401-3975
Phone
(970) 249-4213
Fax
(970) 240-8094
NPI assigned
Dec 15, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2010

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

Authorized official

Name
Amber Ann Smith, D.C.
Title
President
Phone
(970) 249-4213

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 6575 CO Primary

Addresses

Primary practice location

700 E Main St
Montrose, CO 81401-3975

Mailing address

700 E Main St
Montrose, CO 81401-3975
Phone (970) 249-4213

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110509000160 CO Part B Supplier - Clinic/Group Practice 3173708161 Receives reassigned benefits from 1 practitioner
Practice locations: Montrose, CO

National Provider Directory

National Provider Directory

Locations

701 E Main St
Ste D
Montrose, CO 81401
Phone (970) 249-4213

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1292371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292371200000",
    "number": "1831492693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 E MAIN ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013975",
            "telephone_number": "970-249-4213",
            "fax_number": "970-240-8094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 E MAIN ST",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814013975",
            "telephone_number": "970-249-4213",
            "fax_number": "970-240-8094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESA FAMILY CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-15",
        "last_updated": "2010-12-15",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "AMBER",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "970-249-4213",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6575",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2010; 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.