Individual provider Active NPI

David Philip Gavron

  • Chiropractor
  • West Bloomfield, MI
National Provider Identifier
1083021208
Registry record updated Jul 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010239 Issued in MI
Practice address
5829 W Maple Rd
Suite 123
West Bloomfield, MI 48322-2294
Phone
(248) 737-8066
Fax
(248) 757-2209
NPI assigned
Jul 21, 2014
Last updated
Jul 21, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010239 MI Primary

Addresses

Primary practice location

5829 W Maple Rd
Suite 123
West Bloomfield, MI 48322-2294

Mailing address

5829 W Maple Rd
Suite 123
West Bloomfield, MI 48322-2294
Phone (248) 737-8066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150624002195 MI Practitioner - Chiropractic 5395056832 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

49100 Pontiac TRL
Wixom, MI 48393-2569
Phone (248) 669-1109

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alternative Healing Chiropractic Center, PLLC Chiropractor CurrentSince May 28, 2015 Accepting new patients

Locations

49100 Pontiac Trl
Wixom, MI 48393
Phone (248) 669-1108

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1405900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405900800000",
    "number": "1083021208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5829 W MAPLE RD",
            "address_2": "SUITE 123",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222294",
            "telephone_number": "248-737-8066",
            "fax_number": "248-757-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5829 W MAPLE RD",
            "address_2": "SUITE 123",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222294",
            "telephone_number": "248-737-8066",
            "fax_number": "248-757-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAVRON",
        "first_name": "DAVID",
        "middle_name": "PHILIP",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-21",
        "last_updated": "2014-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010239",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.