Individual provider Active NPI

Scott Philip Zack, D.C.

  • Chiropractor
  • West Bloomfield, MI
National Provider Identifier
1013964451
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008619 Issued in MI
Practice address
5761 W Maple Rd
West Bloomfield, MI 48322-2270
Phone
(248) 626-6892
Fax
(248) 855-2477
NPI assigned
May 30, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008619 MI Primary

Addresses

Primary practice location

5761 W Maple Rd
West Bloomfield, MI 48322-2270

Mailing address

5761 W Maple Rd
West Bloomfield, MI 48322-2270
Phone (248) 626-6892

Other identifiers 1

IdentifierTypeStateIssuer
4722514MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
2301008619MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Horizon Healthcare Group, PLLC Chiropractor PastSince Mar 1, 2004 Accepting new patients
West Michigan Imaging Partners LLC PastSince Feb 15, 2013 Accepting new patients
Universal Health Group, Inc Chiropractor Past Accepting new patients
Total Toxicology Labs LLC PastSince Jan 23, 2018 Accepting new patients
Health Choice Medical & Chiropractic Centers, P.C. Chiropractor Past Accepting new patients
Universal Health Group, Inc. Chiropractor Past Accepting new patients
Boulder GX PastSince Nov 7, 2022 Accepting new patients

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148947200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1013964451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5761 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222270",
            "telephone_number": "248-626-6892",
            "fax_number": "248-855-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5761 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222270",
            "telephone_number": "248-626-6892",
            "fax_number": "248-855-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZACK",
        "first_name": "SCOTT",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008619",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4722514",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.