Individual provider Active NPI

Samuel Ray Mayfield, D.C.

  • Chiropractor
  • Alexandria, LA
National Provider Identifier
1912298472
Registry record updated Jun 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1607 Issued in LA
Practice address
5419 Jackson Street Ext
Suite B
Alexandria, LA 71303-2322
Phone
(318) 787-2708
Fax
(318) 787-2716
NPI assigned
May 2, 2011
Last updated
Jun 3, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1607 LA Primary

Addresses

Primary practice location

5419 Jackson Street Ext
Suite B
Alexandria, LA 71303-2322

Mailing address

PO Box 12144
Alexandria, LA 71315-2144
Phone (318) 787-2708

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110718000600 LA Practitioner - Chiropractic 5698943678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayfield Advanced Medical LLCGroup PAC ID 8921356684, 2 clinicians

Practice addresses (Care Compare)

5419 Jackson St
Alexandria, LA 71303-2322
Phone (318) 787-2708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1607LAMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Mayfield Chiropractic Lake Charles Chiropractor CurrentSince Jul 8, 2015 Accepting new patients
Mayfield Advanced Medical, LLC CurrentSince Jul 13, 2018 Accepting new patients

Locations

5419 Jackson St
#B
Alexandria, LA 71303
Phone (318) 787-2708

5419 Jackson Street Ext
#B
Alexandria, LA 71303
Phone (318) 787-2708

1709 W Prien Lake Rd
#B
Lake Charles, LA 70601
Phone (337) 474-5201

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.

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307059200000",
    "number": "1912298472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12144",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713152144",
            "telephone_number": "318-787-2708",
            "fax_number": "318-787-2716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5419 JACKSON STREET EXT",
            "address_2": "SUITE B",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713032322",
            "telephone_number": "318-787-2708",
            "fax_number": "318-787-2716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYFIELD",
        "first_name": "SAMUEL",
        "middle_name": "RAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-02",
        "last_updated": "2011-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "LA",
            "license": "1607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2011; 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.