Individual provider Active NPI

Brian Michael Balogh, DC

  • Chiropractor
  • West Bloomfield, MI
National Provider Identifier
1194734186
Registry record updated Aug 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
L762426 Issued in MI
Practice address
5761 W Maple Rd
West Bloomfield, MI 48322-2270
Phone
(248) 626-6892
Fax
(248) 855-2477
NPI assigned
Aug 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X L762426 MI Primary

Addresses

Primary practice location

5761 W Maple Rd
West Bloomfield, MI 48322-2270

Mailing address

1467 Mariner Dr
Walled Lake, MI 48390-3654
Phone (248) 880-8470

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
L762426MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Stoller Clinic PC Dba the Lowen Clinic Chiropractor Past Accepting new patients
Universal Health Group, Inc. Chiropractor Past Accepting new patients
Universal Health Group, Inc Chiropractor Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186012800000",
    "number": "1194734186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1467 MARINER DR",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903654",
            "telephone_number": "248-880-8470",
            "fax_number": "248-855-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5761 W MAPLE RD",
            "city": "WEST BLOOMFIELD",
            "state": "MI",
            "postal_code": "483222270",
            "telephone_number": "248-626-6892",
            "fax_number": "248-855-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALOGH",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "L762426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bloomfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2007; 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.