Active NPI
Susan Christine Dilatush, D.C.
- Chiropractor
- Benton, KY
National Provider Identifier
1871563635
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 5447
- Practice address
- 142 Vine St
Benton, KY 42025-7472 - Phone
- (270) 527-0000
- Fax
- (270) 527-2121
- NPI assigned
- Jan 25, 2006
- Last updated
- Nov 3, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 1545 | AR | |
| Chiropractor | 111N00000X | 1197 | MT | |
| Chiropractor | 111N00000X | 5447 | KY | Primary |
Addresses
Primary practice location
142 Vine St
Benton, KY 42025-7472
Mailing address
PO Box 1095
Benton, KY 42025-1095
Phone (270) 527-0000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5U573 | Other | AR | BLUE CROSS/BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1545 | AR | MD | Chiropractor |
| 1197 | MT | MD | Dental Hygienist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brandon Fitch, P.a. | Chiropractor | Past | Accepting new patients |
| Estes Chiropractic | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Benton, KY
- NPI 1225315203
-
- Preferred Provider Organization
- Bentonville, AR
- NPI 1922207828
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1414972800000",
"number": "1871563635",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1095",
"city": "BENTON",
"state": "KY",
"postal_code": "420251095",
"telephone_number": "270-527-0000",
"fax_number": "270-527-2121"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "142 VINE ST",
"city": "BENTON",
"state": "KY",
"postal_code": "420257472",
"telephone_number": "270-527-0000",
"fax_number": "270-527-2121"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DILATUSH",
"first_name": "SUSAN",
"middle_name": "CHRISTINE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-01-25",
"last_updated": "2014-11-03",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "AR",
"license": "1545",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MT",
"license": "1197",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "KY",
"license": "5447",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS/BLUE SHIELD",
"identifier": "5U573",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.