NPIMap

Organization Active NPI

Mountain Chiropractic, LLC

  • Chiropractor
  • Payson, AZ
National Provider Identifier
1932387511
Registry record updated Mar 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC3716 Issued in AZ
Legal business name
MOUNTAIN CHIROPRACTIC, LLC
Practice address
411 S Beeline Hwy
Suite C
Payson, AZ 85541-4892
Phone
(928) 474-8417
Fax
(928) 474-8417
NPI assigned
Feb 5, 2008
Last updated
Mar 27, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2008

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

Authorized official

Name
Dr. Daniel S. Flake, DC, CCSPNPI 1710945324
Title
President
Phone
(928) 474-8417

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC3716 AZ Primary

Addresses

Primary practice location

411 S Beeline Hwy
Suite C
Payson, AZ 85541-4892

Mailing address

411 S Beeline Hwy
Suite C
Payson, AZ 85541-4892
Phone (928) 474-8417

Other identifiers 1

IdentifierTypeStateIssuer
120589OtherAZPTAN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1202169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206576000000",
    "number": "1932387511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 S BEELINE HWY",
            "address_2": "SUITE C",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414892",
            "telephone_number": "928-474-8417",
            "fax_number": "928-474-8417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 S BEELINE HWY",
            "address_2": "SUITE C",
            "city": "PAYSON",
            "state": "AZ",
            "postal_code": "855414892",
            "telephone_number": "928-474-8417",
            "fax_number": "928-474-8417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-02-05",
        "last_updated": "2008-03-27",
        "status": "A",
        "authorized_official_last_name": "FLAKE",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "928-474-8417",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, CCSP"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "DC3716",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "120589",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2008; 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.