Organization Active NPI

Michigan Specific Chiropractic

  • Chiropractor
  • Commerce TWP, MI
National Provider Identifier
1073725818
Registry record updated Jan 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AR007188 Issued in MI
Legal business name
MICHIGAN SPECIFIC CHIROPRACTIC
Practice address
3396 E West Maple Rd
Commerce TWP, MI 48390-3807
Phone
(248) 960-3599
NPI assigned
May 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2011

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

Authorized official

Name
Dr. Andrew Roberts, D.C.
Title
Owner
Phone
(248) 960-3599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X AR007188 MI Primary

Addresses

Primary practice location

3396 E West Maple Rd
Commerce TWP, MI 48390-3807

Mailing address

3396 E West Maple Rd
Commerce TWP, MI 48390-3807
Phone (248) 960-3599

Other identifiers 4

IdentifierTypeStateIssuer
950F38878OtherMIBCBS GROUP NUMBER
143545301736OtherMIPPOM
4904080MedicaidMI
950F327350OtherMIBCBS INDIVIDUAL

National Provider Directory

National Provider Directory

Locations

3396 E West Maple Rd
Commerce Township, MI 48390
Phone (248) 960-3599

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1295481600000",
    "number": "1073725818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3396 E WEST MAPLE RD",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483903807",
            "telephone_number": "248-960-3599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3396 E WEST MAPLE RD",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "483903807",
            "telephone_number": "248-960-3599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SPECIFIC CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-04",
        "last_updated": "2011-01-20",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-960-3599",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "AR007188",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP NUMBER",
            "identifier": "950F38878",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PPOM",
            "identifier": "143545301736",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4904080",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS INDIVIDUAL",
            "identifier": "950F327350",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.