Individual provider Active NPI

Randolph Henry Doom, D.C.

  • Chiropractor
  • Monroe, MI
National Provider Identifier
1053552836
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007366 Issued in MI
Practice address
975 S Monroe St
Suite C
Monroe, MI 48161-1477
Phone
(734) 241-0560
Fax
(734) 241-3230
NPI assigned
Mar 9, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007366 MI Primary

Addresses

Primary practice location

975 S Monroe St
Suite C
Monroe, MI 48161-1477

Mailing address

975 S Monroe St
Suite C
Monroe, MI 48161-1477
Phone (734) 241-0560

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

State licenses

LicenseStateTypeSpecialty
2301007366MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1053552836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "975 S MONROE ST",
            "address_2": "SUITE C",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481611477",
            "telephone_number": "734-241-0560",
            "fax_number": "734-241-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "975 S MONROE ST",
            "address_2": "SUITE C",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481611477",
            "telephone_number": "734-241-0560",
            "fax_number": "734-241-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOOM",
        "first_name": "RANDOLPH",
        "middle_name": "HENRY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-03-09",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; 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.