NPIMap

Organization Active NPI

Weiss Chiropractic Life Center PLC

  • Chiropractor
  • Novi, MI
National Provider Identifier
1114227063
Registry record updated Dec 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007148 Issued in MI
Legal business name
WEISS CHIROPRACTIC LIFE CENTER PLC
Practice address
44170 W. 12 Mile Rd
Ste 100
Novi, MI 48377
Phone
(248) 624-9393
Fax
(248) 773-8740
NPI assigned
Oct 26, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 12, 2023

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

Authorized official

Name
Dr. Lawrence Robert Weiss, DCNPI 1871635409
Title
Owner
Phone
(248) 624-9393

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 2301007148 MI Primary

Addresses

Primary practice location

44170 W. 12 Mile Rd
Ste 100
Novi, MI 48377

Mailing address

44170 W. 12 Mile Rd
Ste 100
Novi, MI 48377
Phone (248) 624-9393

Other identifiers 5

IdentifierTypeStateIssuer
P99468OtherMIBCN PROVIDER #
3495449MedicaidMI
95035449OtherMIBCBS PROVIDER #
0M69020OtherMIMEDICARE ID- TYPE UNSPECIFIED
168901OtherMISELECTCARE PROVIDER #

Other names 1

  • Weiss Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101104001566 MI Part B Supplier - Clinic/Group Practice 5294929014 Receives reassigned benefits from 5 practitioners
Practice locations: Novi, MI

National Provider Directory

National Provider Directory

Locations

44170 W Twelve Mile Rd
Ste 100
Novi, MI 48377
Phone (248) 624-9393

49295 West Rd
Wixom, MI 48393
Phone (248) 624-9393

Practitioners & affiliated clinicians

Practitioners 5

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": "1288051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702339200000",
    "number": "1114227063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44170 W. 12 MILE RD",
            "address_2": "STE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "248-624-9393",
            "fax_number": "248-624-6010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44170 W. 12 MILE RD",
            "address_2": "STE 100",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "48377",
            "telephone_number": "248-624-9393",
            "fax_number": "248-773-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WEISS CHIROPRACTIC LIFE CENTER PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-26",
        "last_updated": "2023-12-12",
        "certification_date": "2023-12-12",
        "status": "A",
        "authorized_official_last_name": "WEISS",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-624-9393",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007148",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN PROVIDER #",
            "identifier": "P99468",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3495449",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER #",
            "identifier": "95035449",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID- TYPE UNSPECIFIED",
            "identifier": "0M69020",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SELECTCARE PROVIDER #",
            "identifier": "168901",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Weiss Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Novi, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2023; 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.