Organization Active NPI

Jacob Family Chiropractic PLC

  • Chiropractor
  • Metamora, MI
National Provider Identifier
1225223167
Registry record updated Sep 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008846 Issued in MI
Legal business name
JACOB FAMILY CHIROPRACTIC PLC
Practice address
3820 S Lapeer Rd
Metamora, MI 48455-8751
Phone
(810) 678-2414
Fax
(810) 678-3936
NPI assigned
Sep 13, 2007
Last updated
Sep 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2014

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

Authorized official

Name
Mrs. Denise Lee Turonek
Title
Office Manager
Phone
(810) 678-2414

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008846 MI Primary

Addresses

Primary practice location

3820 S Lapeer Rd
Metamora, MI 48455-8751

Mailing address

3820 S Lapeer Rd
Metamora, MI 48455-8751
Phone (810) 678-2414

Other identifiers 2

IdentifierTypeStateIssuer
0D41125OtherMIBCBSM
950D410620OtherMIBCBS PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20131210001697 MI Part B Supplier - Clinic/Group Practice 8022188747 Receives reassigned benefits from 1 practitioner
Practice locations: Metamora, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411430400000",
    "number": "1225223167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 S LAPEER RD",
            "city": "METAMORA",
            "state": "MI",
            "postal_code": "484558751",
            "telephone_number": "810-678-2414",
            "fax_number": "810-678-3936"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 S LAPEER RD",
            "city": "METAMORA",
            "state": "MI",
            "postal_code": "484558751",
            "telephone_number": "810-678-2414",
            "fax_number": "810-678-3936"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JACOB FAMILY CHIROPRACTIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2014-09-23",
        "status": "A",
        "authorized_official_last_name": "TURONEK",
        "authorized_official_first_name": "DENISE",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "810-678-2414",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008846",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0D41125",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN",
            "identifier": "950D410620",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Metamora, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2014; 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.