Organization Active NPI

Butzin Chiropractic Clinic LLC

  • Chiropractor
  • Sterling Heights, MI
National Provider Identifier
1174285811
Registry record updated Oct 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BUTZIN CHIROPRACTIC CLINIC LLC
Doing business as
Butzin Chiropractic Clinic LLC
Practice address
2050 Chesley Dr
Sterling Heights, MI 48310-4818
Phone
(586) 268-8882
NPI assigned
Oct 11, 2021
Last updated
Oct 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2021

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

Authorized official

Name
Lori A Matoshko
Title
Practice Manager
Phone
(586) 268-8882

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

2050 Chesley Dr
Sterling Heights, MI 48310-4818

Mailing address

57540 Stonebriar Dr
Washington, MI 48094-3168
Phone (586) 268-8882

Other identifiers 1

IdentifierTypeStateIssuer
2134015MedicaidMI

Other names 1

  • Butzin Chiropractic Clinic LLC Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220414000482 MI Part B Supplier - Clinic/Group Practice 3476949769 Receives reassigned benefits from 1 practitioner
Practice locations: Sterling Heights, MI

National Provider Directory

National Provider Directory

Locations

2050 Chesley Dr
Sterling Hts, MI 48310
Phone (586) 268-8882

Practitioners & affiliated clinicians

Practitioners 3

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": "1633910400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633910400000",
    "number": "1174285811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57540 STONEBRIAR DR",
            "city": "WASHINGTON",
            "state": "MI",
            "postal_code": "480943168",
            "telephone_number": "586-268-8882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 CHESLEY DR",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104818",
            "telephone_number": "586-268-8882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUTZIN CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-11",
        "last_updated": "2021-10-11",
        "certification_date": "2021-10-11",
        "status": "A",
        "authorized_official_last_name": "MATOSHKO",
        "authorized_official_first_name": "LORI",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "586-268-8882"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2134015",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Butzin Chiropractic Clinic LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2021; 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.