Advanced Care Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

ADVANCED CARE CHIROPRACTIC PC

Practice address

3160 W Silver Lake Rd Ste B
Fenton, MI 48430-1321

Phone

(248) 328-9800

NPI assigned

Feb 12, 2024

Organization subpart

Yes

Parent organization

ADVANCED CARE CHIROPRACTIC P.C.As reported in NPPES

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

Authorized official

Name

Misty L White

Title

Coo

Phone

(248) 328-9800

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Advanced Care Chiropractic PC

  • Chiropractor
  • Holly, MI
  • NPI 1306038732

  O20050412001015

  Same enrollment

Tax ID family

Advanced Care Chiro PC2 organizations share this tax ID, including this one

Part of

Advanced Care Chiro PC

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Advanced Care Chiropractic PC

  • Chiropractor
  • Holly, MI
  • NPI 1306038732
  NPD tax ID

Locations

Practitioners 2

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

• John Anthony Prevost III, DC

  • Chiropractor
  • Holly, MI
  • NPI 1134856305
  NPD
• Jason Mathieu White, D.C.

  • Chiropractor
  • Holly, MI
  • NPI 1841206315
  NPD

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

{
    "created_epoch": "1707696000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707696000000",
    "number": "1003670753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16331 SILVER LANDINGS",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484309184",
            "telephone_number": "810-280-4505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3160 W SILVER LAKE RD STE B",
            "city": "FENTON",
            "state": "MI",
            "postal_code": "484301321",
            "telephone_number": "248-328-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CARE CHIROPRACTIC PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ADVANCED CARE CHIROPRACTIC P.C.",
        "enumeration_date": "2024-02-12",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-09",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "MISTY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "248-328-9800"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1306038732",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Fenton, MI
• Providers in Fenton, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; 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.