NPIMap

Organization Active NPI

Nichole C. Anderson DC LLC

  • Chiropractor
  • Detroit, MI
National Provider Identifier
1154577435
Registry record updated Jan 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008912 Issued in MI
Legal business name
NICHOLE C. ANDERSON DC LLC
Practice address
3702 E 8 Mile Rd
Detroit, MI 48234-1007
Phone
(313) 891-1800
Fax
(313) 891-1802
NPI assigned
Aug 18, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2013

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

Authorized official

Name
Nichole C Anderson, DC
Title
Owner
Phone
(313) 891-1800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301008912 MI Primary

Addresses

Primary practice location

3702 E 8 Mile Rd
Detroit, MI 48234-1007

Mailing address

3702 E 8 Mile Rd
Detroit, MI 48234-1007
Phone (313) 891-1800

Other identifiers 2

IdentifierTypeStateIssuer
4801313MedicaidMI
95-OH225940OtherMIBCBS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1219017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1154577435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3702 E 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341007",
            "telephone_number": "313-891-1800",
            "fax_number": "313-891-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3702 E 8 MILE RD",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482341007",
            "telephone_number": "313-891-1800",
            "fax_number": "313-891-1802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICHOLE C. ANDERSON DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-18",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-891-1800",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008912",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4801313",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "95-OH225940",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.