Individual provider Active NPI

David Lee Panek, DC

  • Chiropractor
  • Flint, MI
National Provider Identifier
1104083195
Registry record updated Oct 21, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
23010002905 Issued in MI
Practice address
3411 Corunna Rd.
Flint, MI 48503-3265
Phone
(810) 767-6221
Fax
(810) 767-4429
NPI assigned
May 19, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 23010002905 MI Primary
Chiropractor 111N00000X 2301009408 MI

Addresses

Primary practice location

3411 Corunna Rd.
Flint, MI 48503-3265

Mailing address

3411 Corunna Rd
Flint, MI 48503-3265
Phone (810) 767-6221

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
23010002905MIMDChiropractor
2301009408MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1211155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256083200000",
    "number": "1104083195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3411 CORUNNA RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485033265",
            "telephone_number": "810-767-6221",
            "fax_number": "810-767-4429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3411 CORUNNA RD.",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485033265",
            "telephone_number": "810-767-6221",
            "fax_number": "810-767-4429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANEK",
        "first_name": "DAVID",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-19",
        "last_updated": "2009-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "23010002905",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009408",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; 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.