Organization Active NPI

Ross Chiropractic PLLC

  • Chiropractor
  • Davison, MI
National Provider Identifier
1235338864
Registry record updated Oct 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004832 Issued in MI
Legal business name
ROSS CHIROPRACTIC PLLC
Practice address
208 N Main St Ste B
Davison, MI 48423-1432
Phone
(248) 321-5405
Fax
(810) 797-3615
NPI assigned
Jul 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2021

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

Authorized official

Name
Dr. Wallace Charles Ross, DCNPI 1154365708
Title
President
Phone
(248) 321-5405

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 2301004832 MI Primary

Addresses

Primary practice location

208 N Main St Ste B
Davison, MI 48423-1432

Mailing address

208 N Main St
Davison, MI 48423-1432
Phone (248) 321-5405

Other identifiers 1

IdentifierTypeStateIssuer
950E034930OtherMIBCBSM

National Provider Directory

National Provider Directory

Locations

208 N Main St
Ste B
Davison, MI 48423
Phone (248) 321-5405

208 N Main St
Davison, MI 48423
Phone (248) 321-5405

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": "1184284800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1634601600000",
    "number": "1235338864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 N MAIN ST",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484231432",
            "telephone_number": "248-321-5405",
            "fax_number": "810-797-3615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 N MAIN ST STE B",
            "city": "DAVISON",
            "state": "MI",
            "postal_code": "484231432",
            "telephone_number": "248-321-5405",
            "fax_number": "810-797-3615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROSS CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-13",
        "last_updated": "2021-10-19",
        "certification_date": "2021-10-19",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-321-5405",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "950E034930",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davison, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2021; 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.