Organization Active NPI

Dillon Back & Neck Clinic PC

  • Chiropractor
  • Dillon, MT
National Provider Identifier
1891811733
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
903 Issued in MT
Legal business name
DILLON BACK & NECK CLINIC PC
Practice address
330 S Idaho St
Dillon, MT 59725-2532
Phone
(406) 683-9600
NPI assigned
Mar 22, 2007
Last updated
Mar 23, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Authorized official

Name
Dr. Andrew James Belice, D.C.NPI 1538202882
Title
Owner Doctor
Phone
(406) 683-9600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 903 MT Primary

Addresses

Primary practice location

330 S Idaho St
Dillon, MT 59725-2532

Mailing address

330 S Idaho St
Dillon, MT 59725-2532
Phone (406) 683-9600

Other identifiers 4

IdentifierTypeStateIssuer
350054899OtherMTRAILROAD MEDICARE
0162945MedicaidMT
0162928MedicaidMT
41921OtherMTBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040323001678 MT Part B Supplier - Clinic/Group Practice 8022909522 Receives reassigned benefits from 1 practitioner
Practice locations: Dillon, MT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1332460800000",
    "number": "1891811733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S IDAHO ST",
            "city": "DILLON",
            "state": "MT",
            "postal_code": "597252532",
            "telephone_number": "406-683-9600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S IDAHO ST",
            "city": "DILLON",
            "state": "MT",
            "postal_code": "597252532",
            "telephone_number": "406-683-9600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DILLON BACK & NECK CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2012-03-23",
        "status": "A",
        "authorized_official_last_name": "BELICE",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER DOCTOR",
        "authorized_official_telephone_number": "406-683-9600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MT",
            "license": "903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350054899",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162945",
            "state": "MT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0162928",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "41921",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dillon, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2012; 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.