NPI |
1013287911 |
The name of the organization provider. If the provider is an organization, this is the legal business name. |
Entity Type Code |
2 |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Employer Identification Number EIN |
|
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot
include a Post Office box. |
Provider Organization Name Legal Business Name |
MIKELL ADAMS DC, PA |
The city name in the location address of the provider being identified. |
Provider First Line Business Practice Location Address |
1201 WAKARUSA DR |
The State code in the location of the provider
being identified. |
Provider Second Line Business Practice Location Address |
STE A1 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address City Name |
LAWRENCE |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
KS |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Postal Code |
660494722 |
The fax number associated with the location
address of the provider being identified. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
7858389000 |
The date that a record was last updated or changed. |
Provider Business Practice Location Address Fax Number |
7858384177 |
The fax number associated with the location
address of the provider being identified. |
Provider Enumeration Date |
1/9/2012 |
The first name of the authorized official. |
Last Update Date |
1/9/2012 |
The title or position of the authorized official. |
Authorized Official Last Name |
ADAMS |
The 10-position telephone number of the authorized official. |
Authorized Official First Name |
MIKELL |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Authorized Official Title or Position |
CHIROPRACTOR |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
Authorized Official Telephone Number |
7858389000 |
The 10-position telephone number of the authorized official. |
Healthcare Provider Taxonomy Code 1 |
111N00000X |
Code designating the provider type, classification,
and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1. |
Provider License Number 1 |
01-04118 |
The license number issued to the provider being identified. The NPS can accommodate
multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’. |
Provider License Number State Code 1 |
KS |
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Organization Subpart |
N |
|
Authorized Official Credential Text |
D.C. |
|
Healthcare Provider Taxonomy Group 1 |
193400000X SINGLE SPECIALTY GROUP |
|