Organization Active NPI

Reid Chiropractic Clinic PC

  • Chiropractor
  • Troy, MI
National Provider Identifier
1144570755
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CR004874 Issued in MI
Legal business name
REID CHIROPRACTIC CLINIC PC
Practice address
5877 Livernois Rd
Suite 104
Troy, MI 48098-3100
Phone
(248) 828-8300
Fax
(248) 828-9460
NPI assigned
Sep 12, 2012
Last updated
Sep 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

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

Authorized official

Name
Dr. Charles Reid, D.CNPI 1376607994
Title
Chiropractor
Phone
(248) 828-8300

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 CR004874 MI Primary

Addresses

Primary practice location

5877 Livernois Rd
Suite 104
Troy, MI 48098-3100

Mailing address

5877 Livernois Rd
Suite 104
Troy, MI 48098-3100
Phone (248) 828-8300

Other identifiers 1

IdentifierTypeStateIssuer
0F35222OtherMIBLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121024000740 MI Part B Supplier - Clinic/Group Practice 2961652177 Receives reassigned benefits from 1 practitioner
Practice locations: Rochester Hills, MI

National Provider Directory

National Provider Directory

Locations

2157 Avon Industrial Dr
Rochester Hills, MI 48309
Phone (248) 828-8300

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": "1347408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1347408000000",
    "number": "1144570755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5877 LIVERNOIS RD",
            "address_2": "SUITE 104",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480983100",
            "telephone_number": "248-828-8300",
            "fax_number": "248-828-9460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5877 LIVERNOIS RD",
            "address_2": "SUITE 104",
            "city": "TROY",
            "state": "MI",
            "postal_code": "480983100",
            "telephone_number": "248-828-8300",
            "fax_number": "248-828-9460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REID CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A",
        "authorized_official_last_name": "REID",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "248-828-8300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "CR004874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0F35222",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Troy, MI

Sources for this page

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