Organization Active NPI

Frederick Chiropractic Clinic, Inc

  • Chiropractor
  • Howell, MI
National Provider Identifier
1144421603
Registry record updated Oct 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007587 Issued in MI
Legal business name
FREDERICK CHIROPRACTIC CLINIC, INC
Practice address
1221 Byron Rd
Suite 4
Howell, MI 48843-1069
Phone
(517) 552-3132
Fax
(517) 552-8463
NPI assigned
May 30, 2007
Last updated
Oct 1, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2012

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

Authorized official

Name
Dr. Amy Frederick Buck, D.C.NPI 1255436341
Title
Owner
Phone
(517) 552-3132

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
Chiropractor 111N00000X 2301007587 MI Primary

Addresses

Primary practice location

1221 Byron Rd
Suite 4
Howell, MI 48843-1069

Mailing address

1221 Byron Rd
Suite 4
Howell, MI 48843-1069
Phone (517) 552-3132

Other identifiers 1

IdentifierTypeStateIssuer
2301007587OtherMILICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060502000261 MI Part B Supplier - Clinic/Group Practice 0042220352 Receives reassigned benefits from 1 practitioner
Practice locations: Howell, MI

National Provider Directory

National Provider Directory

Locations

184 Thomas Johnson Dr
Ste 174
Frederick, MD 21702

1004 S Michigan Ave
Ste 103
Howell, MI 48843
Phone (517) 552-3132

1221 Byron Rd
Ste 4
Howell, MI 48843
Phone (517) 552-3132

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1349049600000",
    "number": "1144421603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 BYRON RD",
            "address_2": "SUITE 4",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431069",
            "telephone_number": "517-552-3132",
            "fax_number": "517-552-8463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 BYRON RD",
            "address_2": "SUITE 4",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488431069",
            "telephone_number": "517-552-3132",
            "fax_number": "517-552-8463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREDERICK CHIROPRACTIC CLINIC, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2012-10-01",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "FREDERICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-552-3132",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007587",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2301007587",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Howell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2012; 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.