NPIMap

Organization Active NPI

Prodigy Spinal Rehabiliation

  • Chiropractor
  • Dearborn, MI
National Provider Identifier
1154623833
Registry record updated Dec 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PRODIGY SPINAL REHABILIATION
Practice address
6309 Schaefer Rd
Dearborn, MI 48126-2210
Phone
(313) 846-9100
Fax
(313) 846-9104
NPI assigned
Dec 1, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2010

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

Authorized official

Name
Dr. Summer Fakhouri, DCNPI 1487832184
Title
Chiropractor
Phone
(313) 846-9100

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 Primary

Addresses

Primary practice location

6309 Schaefer Rd
Dearborn, MI 48126-2210

Mailing address

6309 Schaefer Rd
Dearborn, MI 48126-2210
Phone (313) 846-9100

National Provider Directory

National Provider Directory

Locations

6309 Schaefer Rd
Dearborn, MI 48126
Phone (313) 846-9100

Practitioners & affiliated clinicians

Practitioners 1

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": "1291161600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291161600000",
    "number": "1154623833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6309 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262210",
            "telephone_number": "313-846-9100",
            "fax_number": "313-846-9104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6309 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262210",
            "telephone_number": "313-846-9100",
            "fax_number": "313-846-9104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRODIGY SPINAL REHABILIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-01",
        "last_updated": "2010-12-01",
        "status": "A",
        "authorized_official_last_name": "FAKHOURI",
        "authorized_official_first_name": "SUMMER",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "313-846-9100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2010; 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.