Michael J. Dibley, D.C., P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

08000910 Issued in IN

Legal business name

MICHAEL J. DIBLEY, D.C., P.C.

Practice address

1709 E Bristol St
Elkhart, IN 46514-6606

Phone

(574) 264-9174

NPI assigned

Oct 13, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Michael J Dibley, D.C., C.C.S.P.NPI 1245363696

Title

Owner

Phone

(574) 264-9174

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Practitioners 2

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

• Michael John Dibley Jr., D.C.,C.C.S.P

  • Sports Physician Chiropractor
  • Elkhart, IN
  • NPI 1245363696
  Medicare reassignment Care Compare group NPD Authorized official
• Michael Dean Hummer, DC

  • Chiropractor
  • Mishawaka, IN
  • NPI 1700519949
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1223856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223856000000",
    "number": "1861644676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1709 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465146606",
            "telephone_number": "574-264-9174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1709 E BRISTOL ST",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465146606",
            "telephone_number": "574-264-9174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL J. DIBLEY, D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-13",
        "last_updated": "2008-10-13",
        "status": "A",
        "authorized_official_last_name": "DIBLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "574-264-9174",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., C.C.S.P."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08000910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100112670",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Michiana Eye Center , LLC
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• Chiropractor in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2008; 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.