Ican Clinic Mo PC

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

Legal business name

ICAN CLINIC MO PC

Practice address

106 Four Seasons Shopping Ctr Ste 110
Chesterfield, MO 63017-3173

Phone

(618) 254-2273

NPI assigned

Nov 16, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Michael Harbison, DC

Title

Owner

Phone

(618) 254-2273

Specialties & licenses 2

Addresses

Other names 1

• ICAN CLINIC MO PC Other name

Electronic endpoints 1

Locations

Interoperability endpoints

• Direct secure messaging: icanclinicllc@direct.practicefusion.com

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1637020800000",
    "number": "1992461776",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 FOUR SEASONS SHOPPING CTR STE 110",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173173",
            "telephone_number": "618-254-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 FOUR SEASONS SHOPPING CTR STE 110",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173173",
            "telephone_number": "618-254-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ICAN CLINIC MO PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A",
        "authorized_official_last_name": "HARBISON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-254-2273",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "icanclinicllc@direct.practicefusion.com",
            "affiliation": "N",
            "endpointDescription": "EHR Communications",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "106 Four Seasons Shopping Ctr # 110",
            "city": "Chesterfield",
            "state": "MO",
            "country_code": "US",
            "postal_code": "630173173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "ICAN CLINIC MO PC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Charles Daniel Hurley, DDS
• Edward Joseph Hurley, M.D.
• Emily Hurley, DDS
• Kathleen L Hurley, MD
• Alsa Hussain, MD
• Ignite Performance and Health
• Iiikingz LLC
• Charlotte Virginia Ijei, M.ED.
• Lindsey Marie Illinger, A-GNP-C
• Illinois Hospitalists, PC

• Surgery Physician in Chesterfield, MO
• Providers in Chesterfield, MO by specialty
• Surgery Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; 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.