Active NPI
Reza Hafezi, D.C.
- Chiropractor
- Detroit, MI
National Provider Identifier
1093126872
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301007342
- Practice address
- 17600 W. Warren Ave.
Detroit, MI 48228 - Phone
- (313) 420-9655
- NPI assigned
- May 14, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301007342 | MI | Primary |
Addresses
Primary practice location
17600 W. Warren Ave.
Detroit, MI 48228
Mailing address
17600 W. Warren Ave.
Detroit, MI 48228
Phone (313) 420-9655
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301007342 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1400025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1400025600000",
"number": "1093126872",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17600 W. WARREN AVE.",
"city": "DETROIT",
"state": "MI",
"postal_code": "48228",
"telephone_number": "313-420-9655",
"fax_number": "313-240-6557"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17600 W. WARREN AVE.",
"city": "DETROIT",
"state": "MI",
"postal_code": "48228",
"telephone_number": "313-420-9655"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAFEZI",
"first_name": "REZA",
"name_prefix": "Mr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-05-14",
"last_updated": "2014-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301007342",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.