Organization Active NPI

McLeod Eastpointe Chiropractic, PC

  • Chiropractor
  • Eastpointe, MI
National Provider Identifier
1083734446
Registry record updated Jul 25, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005579 Issued in MI
Legal business name
MCLEOD EASTPOINTE CHIROPRACTIC, PC
Practice address
21349 Kelly Rd
Eastpointe, MI 48021-3217
Phone
(586) 774-8492
NPI assigned
Mar 30, 2007
Last updated
Jul 25, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2007

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

Authorized official

Name
Dr. Douglas Allen McLeod, D.O.NPI 1780737619
Title
President
Phone
(586) 774-8492

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301005579 MI Primary

Addresses

Primary practice location

21349 Kelly Rd
Eastpointe, MI 48021-3217

Mailing address

21349 Kelly Rd
Eastpointe, MI 48021-3217
Phone (586) 774-8492

Other identifiers 2

IdentifierTypeStateIssuer
950E05248OtherMIBLUE CROSS MI
2693066MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070723000334 MI Part B Supplier - Clinic/Group Practice 1456452366 Receives reassigned benefits from 1 practitioner
Practice locations: Eastpointe, MI

National Provider Directory

National Provider Directory

Locations

21349 Kelly Rd
Eastpointe, MI 48021
Phone (586) 774-7788

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1175212800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185321600000",
    "number": "1083734446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21349 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213217",
            "telephone_number": "586-774-8492"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21349 KELLY RD",
            "city": "EASTPOINTE",
            "state": "MI",
            "postal_code": "480213217",
            "telephone_number": "586-774-8492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD EASTPOINTE CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-30",
        "last_updated": "2007-07-25",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-774-8492",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS MI",
            "identifier": "950E05248",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2693066",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastpointe, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.