Hughes Chiropractic Life Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301005457 Issued in MI

Legal business name

HUGHES CHIROPRACTIC LIFE CENTER LLC

Practice address

25010 Ford Rd
Dearborn Heights, MI 48127-3114

Phone

(313) 562-9966

Fax

(313) 562-9617

NPI assigned

May 22, 2007

Reactivated

Feb 4, 2019

Organization subpart

No

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

Authorized official

Name

Laura Wollborg

Title

Office Manager

Phone

(313) 562-9966

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

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

• Kenneth Hughes, D.C.

  • Chiropractor
  • Dearborn Heights, MI
  • NPI 1033267703
  Medicare reassignment NPD
• Elizabeth Sophia Baise-Bergeron, D.C.

  • Chiropractor
  • Plymouth, MI
  • NPI 1538239371
  NPD (past)

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635724800000",
    "number": "1073722310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25010 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273114",
            "telephone_number": "313-562-9966",
            "fax_number": "313-562-9617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25010 FORD RD",
            "city": "DEARBORN HEIGHTS",
            "state": "MI",
            "postal_code": "481273114",
            "telephone_number": "313-562-9966",
            "fax_number": "313-562-9617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUGHES CHIROPRACTIC LIFE CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2021-11-01",
        "certification_date": "2021-11-01",
        "deactivation_date": "2009-05-06",
        "reactivation_date": "2019-02-04",
        "status": "A",
        "authorized_official_last_name": "WOLLBORG",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "313-562-9966"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2789800",
            "state": "MI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hugheschiro@sbcglobal.net",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "25010 Ford Rd",
            "city": "Dearborn Heights",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481273114",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Horton
• Amy Marie Hoskin, LBSW, LLPC
• Latonya Denise Howard, LMSW
• Rovena Hoxha, RPH
• Contecia Hudson-Williams
• Kenneth Hughes, D.C.
• Enida Huremovic, MOTRL
• Sedria Hussain
• Hussein Mohsen Hussein
• HWP PLLC (Stat Telemedicine & Walk-In)

• Chiropractor in Dearborn Heights, MI
• Providers in Dearborn Heights, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; 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.