Individual provider Active NPI

Michael George Mack, D.C.

  • Chiropractor
  • Bottineau, ND
National Provider Identifier
1851737589
Registry record updated Apr 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
947 Issued in ND
Practice address
909 11TH St E
Bottineau, ND 58318-1855
Phone
(701) 228-2275
Fax
(701) 228-3080
NPI assigned
May 21, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 947 ND Primary

Addresses

Primary practice location

909 11TH St E
Bottineau, ND 58318-1855

Mailing address

909 11TH St E
Bottineau, ND 58318-1855
Phone (701) 228-2275

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140428002001 ND Practitioner - Chiropractic 3678704277 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
True North Chiropractic PC 3 clinicians

Practice addresses (Care Compare)

909 11TH St E
Bottineau, ND 58318-1855
Phone (701) 228-2275

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
True North Chiropractic, PC Chiropractor CurrentSince Jan 1, 2016 Accepting new patients

Locations

909 11th St E
Bottineau, ND 58318
Phone (701) 228-2275

Organizations & group practices 1

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": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1650499200000",
    "number": "1851737589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "909 11TH ST E",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181855",
            "telephone_number": "701-228-2275",
            "fax_number": "701-228-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 11TH ST E",
            "city": "BOTTINEAU",
            "state": "ND",
            "postal_code": "583181855",
            "telephone_number": "701-228-2275",
            "fax_number": "701-228-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACK",
        "first_name": "MICHAEL",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-21",
        "last_updated": "2022-04-21",
        "certification_date": "2022-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ND",
            "license": "947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bottineau, ND

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2022; 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.