Main Street Chiro LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MAIN STREET CHIRO LLC

Doing business as

Main Street Chiropractic

Practice address

24 W Main St
Middletown, DE 19709-1039

Phone

(856) 904-3061

Fax

(215) 332-8691

NPI assigned

Aug 3, 2022

Organization subpart

No

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

Authorized official

Name

Dr. Tarak Navin Patel, DC

Title

Owner/Provider

Phone

(856) 904-3061

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Main Street Chiropractic Doing business as

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1659484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659484800000",
    "number": "1881321560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 W MAIN ST",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091039",
            "telephone_number": "856-904-3061",
            "fax_number": "215-332-8691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 W MAIN ST",
            "city": "MIDDLETOWN",
            "state": "DE",
            "postal_code": "197091039",
            "telephone_number": "856-904-3061",
            "fax_number": "215-332-8691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAIN STREET CHIRO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-08-03",
        "last_updated": "2022-08-03",
        "certification_date": "2022-07-26",
        "status": "A",
        "authorized_official_last_name": "PATEL",
        "authorized_official_first_name": "TARAK",
        "authorized_official_middle_name": "NAVIN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "856-904-3061",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1036188000001",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PERSONAL NPI",
            "identifier": "1083056683",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.mayfairchiro.com",
            "affiliation": "N",
            "endpointDescription": "website",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "24 W Main St",
            "city": "Middletown",
            "state": "DE",
            "country_code": "US",
            "postal_code": "197091039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Main Street Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Debra Ann Lynch, GNP
• William Ray Lynch Jr., M.D.
• Gary S. Lytle, MD
• Erin Macfadyen, BSN,RN
• Maggie Magpie Inc
• Main Street Chiropractic
• Kristen Paige Malin, DPT
• Alex Mallari, CRNA
• Meredith Malone, EDD, MSN, RN
• Kristin Andrea Maloney, LPCMH, NCC

• Chiropractor in Middletown, DE
• Providers in Middletown, DE by specialty
• Chiropractor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.