John Anthony Prevost III, DC
Individual provider Active NPI Chiropractor · Holly, MI
NPI 1134856305 · NPPES record last updated Aug 6, 2022
Key facts
- NPI
- 1134856305
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2301401273 (MI)
- Practice address
- 1016 N Saginaw St
Holly, MI 48442-1379 - Phone
- (248) 328-9800
- NPI assigned
- Aug 6, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - West Sunnyvale, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Advanced Care Chiropractic PC
Practice addresses (Care Compare)
1016 N Saginaw St
Suite a
Holly, MI 48442-1379
Phone (248) 328-9800
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220830002754 | MI | Practitioner - Chiropractic | 4385028018 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Care Chiropractic PC | Chiropractor | Current |
Accepting new patients |
| Advanced Care Chiropractic PC | Chiropractor | Current |
Accepting new patients |
Locations
3160 W Silver Lake Rd
#B
Fenton, MI 48430
Phone (248) 328-9800
1016 N Saginaw St
Ste A
Holly, MI 48442
Phone (248) 328-9800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301401273 | MI | Yes |
Addresses
Primary practice location
1016 N Saginaw St
Holly, MI 48442-1379
Mailing address
2462 Golden Shore Dr
Fenton, MI 48430-1051
Phone (810) 247-2551
Other providers in Holly, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.