Balanced Living Chiropractic of Rochester PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301009314 Issued in MI

Legal business name

BALANCED LIVING CHIROPRACTIC OF ROCHESTER PLLC

Practice address

1000 W University Dr
Suite 202
Rochester, MI 48307-1873

Phone

(248) 652-7225

Fax

(248) 652-7292

NPI assigned

Jun 25, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Richard Anthony Cicala, D.C.NPI 1780882043

Title

Owner/D.C.

Phone

(248) 652-7225

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

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

• Richard Anthony Cicala, D.C.

  • Chiropractor
  • Rochester, MI
  • NPI 1780882043
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216944000000",
    "number": "1003078700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 W UNIVERSITY DR",
            "address_2": "SUITE 202",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071873",
            "telephone_number": "248-652-7225",
            "fax_number": "248-652-7292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 W UNIVERSITY DR",
            "address_2": "SUITE 202",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071873",
            "telephone_number": "248-652-7225",
            "fax_number": "248-652-7292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIVING CHIROPRACTIC OF ROCHESTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2008-07-25",
        "status": "A",
        "authorized_official_last_name": "CICALA",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER/D.C.",
        "authorized_official_telephone_number": "248-652-7225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009314",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "95-0-F3-5689-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Rochester, MI
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2008; 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.