Organization Active NPI

Cadillac Chiropractic Center PC

  • Chiropractor
  • Cadillac, MI
National Provider Identifier
1174619464
Registry record updated Oct 3, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CADILLAC CHIROPRACTIC CENTER PC
Practice address
302 E Cass St
Cadillac, MI 49601-2170
Phone
(231) 775-8087
Fax
(231) 775-8097
NPI assigned
Oct 5, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2007

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

Authorized official

Name
Scott Reagan, DCNPI 1659467942
Title
President
Phone
(231) 775-8087

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

302 E Cass St
Cadillac, MI 49601-2170

Mailing address

PO Box 428
Cadillac, MI 49601-0428
Phone (231) 775-6076

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071120000079 MI Part B Supplier - Clinic/Group Practice 3072601301 Receives reassigned benefits from 1 practitioner
Practice locations: Cadillac, MI

National Provider Directory

National Provider Directory

Locations

1037 N Mitchell St
Ste 10B
Cadillac, MI 49601
Phone 2317756076226

1037 N Mitchell St
#10B
Cadillac, MI 49601

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": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1191369600000",
    "number": "1174619464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 428",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496010428",
            "telephone_number": "231-775-6076",
            "fax_number": "231-775-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 E CASS ST",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496012170",
            "telephone_number": "231-775-8087",
            "fax_number": "231-775-8097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CADILLAC CHIROPRACTIC CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-10-03",
        "status": "A",
        "authorized_official_last_name": "REAGAN",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-775-8087",
        "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 Cadillac, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2007; 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.