Organization Active NPI

South Lyon Chiropractic PLLC

  • Chiropractor
  • South Lyon, MI
National Provider Identifier
1073812293
Registry record updated Apr 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009723 Issued in MI
Legal business name
SOUTH LYON CHIROPRACTIC PLLC
Practice address
327 N Lafayette St
South Lyon, MI 48178-4002
Phone
(734) 306-2454
NPI assigned
Mar 28, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2012

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

Authorized official

Name
Dr. Jamie J Penn, D.C.
Title
President
Phone
(734) 306-2454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301009723 MI Primary

Addresses

Primary practice location

327 N Lafayette St
South Lyon, MI 48178-4002

Mailing address

7838 5 Mile Rd
Northville, MI 48168-9448
Phone (734) 306-2454

National Provider Directory

National Provider Directory

Locations

3875 Packard St
Ann Arbor, MI 48108
Phone (734) 971-2225

327 N Lafayette St
South Lyon, MI 48178
Phone (248) 486-1411

Practitioners & affiliated clinicians

Practitioners 3

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": "1301270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334188800000",
    "number": "1073812293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7838 5 MILE RD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481689448",
            "telephone_number": "734-306-2454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 N LAFAYETTE ST",
            "city": "SOUTH LYON",
            "state": "MI",
            "postal_code": "481784002",
            "telephone_number": "734-306-2454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH LYON CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-03-28",
        "last_updated": "2012-04-12",
        "status": "A",
        "authorized_official_last_name": "PENN",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-306-2454",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Lyon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2012; 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.