Organization Active NPI

Lukosavich Chiropractic Center PC

  • Chiropractor
  • Shelby Township, MI
National Provider Identifier
1114043254
Registry record updated Apr 2, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008617 Issued in MI
Legal business name
LUKOSAVICH CHIROPRACTIC CENTER PC
Practice address
48881 Hayes Rd
Shelby Township, MI 48315-4405
Phone
(586) 532-6373
Fax
(586) 532-6372
NPI assigned
Mar 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2013

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

Authorized official

Name
Dr. Marc A Lukosavich, D.C.NPI 1023039955
Title
Doctorowner
Phone
(586) 532-6373

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301008617 MI Primary

Addresses

Primary practice location

48881 Hayes Rd
Shelby Township, MI 48315-4405

Mailing address

48881 Hayes Rd
Shelby Township, MI 48315-4405

Other identifiers 1

IdentifierTypeStateIssuer
950E018380OtherMIBCBS OF MICHIGAN

Other names 1

  • Lukosavich Chiropractic Center Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060317000091 MI Part B Supplier - Clinic/Group Practice 2668489519 Receives reassigned benefits from 1 practitioner
Practice locations: Shelby Township, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1364860800000",
    "number": "1114043254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48881 HAYES RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48881 HAYES RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483154405",
            "telephone_number": "586-532-6373",
            "fax_number": "586-532-6372"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUKOSAVICH CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2013-04-02",
        "status": "A",
        "authorized_official_last_name": "LUKOSAVICH",
        "authorized_official_first_name": "MARC",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "DOCTOROWNER",
        "authorized_official_telephone_number": "586-532-6373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008617",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MICHIGAN",
            "identifier": "950E018380",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lukosavich Chiropractic Center",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2013; 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.