Organization Active NPI

Summit Chiropractic P.a.

  • Chiropractor
  • Havre de Grace, MD
National Provider Identifier
1932525557
Registry record updated Mar 6, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
S03696 Issued in MD
Legal business name
SUMMIT CHIROPRACTIC P.A.
Practice address
2129 Pulaski Hwy Ste 103
Havre de Grace, MD 21078-2141
Phone
(443) 327-6545
NPI assigned
Mar 6, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2014

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

Authorized official

Name
Dr. Tyler Fino Smardzewski, D.C.NPI 1619393618
Title
Owner
Phone
(443) 417-7729

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X S03696 MD Primary

Addresses

Primary practice location

2129 Pulaski Hwy Ste 103
Havre de Grace, MD 21078-2141

Mailing address

2129 Pulaski Hwy Ste 103
Havre de Grace, MD 21078-2141
Phone (443) 327-6545

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140513000753 MD Part B Supplier - Clinic/Group Practice 5193958478 Receives reassigned benefits from 1 practitioner
Practice locations: Havre de Grace, MD

National Provider Directory

National Provider Directory

Locations

2129 Pulaski Hwy
Ste 103
Hvre de Grace, MD 21078
Phone (443) 327-6545

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1394064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394064000000",
    "number": "1932525557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 PULASKI HWY STE 103",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782141",
            "telephone_number": "443-327-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 PULASKI HWY STE 103",
            "city": "HAVRE DE GRACE",
            "state": "MD",
            "postal_code": "210782141",
            "telephone_number": "443-327-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMIT CHIROPRACTIC P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-06",
        "last_updated": "2014-03-06",
        "status": "A",
        "authorized_official_last_name": "SMARDZEWSKI",
        "authorized_official_first_name": "TYLER",
        "authorized_official_middle_name": "FINO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "443-417-7729",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MD",
            "license": "S03696",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Havre de Grace, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2014; 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.