Organization Active NPI

Anderson Hamo Chiropractic, PLC

  • Chiropractor
  • Flint, MI
National Provider Identifier
1245243419
Registry record updated Apr 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
008899 Issued in MI
Legal business name
ANDERSON HAMO CHIROPRACTIC, PLC
Practice address
1174 W Hill Rd
Suite 2
Flint, MI 48507-4776
Phone
(810) 238-9066
Fax
(810) 238-9139
NPI assigned
Aug 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2008

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

Authorized official

Name
Dr. Tera Hamo Anderson, D.C.NPI 1801881925
Title
Member
Phone
(810) 238-9066

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 008899 MI Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 008894 MI
Nutrition ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN1001X 008894 MI
Sports Physician ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NS0005X 008899 MI

Addresses

Primary practice location

1174 W Hill Rd
Suite 2
Flint, MI 48507-4776

Mailing address

1174 W Hill Rd
Suite 2
Flint, MI 48507-4776
Phone (810) 238-9066

Other identifiers 3

IdentifierTypeStateIssuer
4775830MedicaidMI
4775821MedicaidMI
950B513500OtherMIBCBSM GROUP PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050707000453 MI Part B Supplier - Clinic/Group Practice 2062458425 Receives reassigned benefits from 2 practitioners
Practice locations: Grand Blanc, MI

National Provider Directory

National Provider Directory

Locations

1174 W Hill Rd
Ste 2
Flint, MI 48507
Phone (810) 238-9066

2201 E Hill Rd
Grand Blanc, MI 48439
Phone (810) 771-7736

Practitioners & affiliated clinicians

Practitioners 2

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": "1155600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208649600000",
    "number": "1245243419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1174 W HILL RD",
            "address_2": "SUITE 2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485074776",
            "telephone_number": "810-238-9066",
            "fax_number": "810-238-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1174 W HILL RD",
            "address_2": "SUITE 2",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485074776",
            "telephone_number": "810-238-9066",
            "fax_number": "810-238-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSON HAMO CHIROPRACTIC, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-15",
        "last_updated": "2008-04-20",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "TERA",
        "authorized_official_middle_name": "HAMO",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "810-238-9066",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "008899",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "008894",
            "primary": false
        },
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "MI",
            "license": "008894",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "MI",
            "license": "008899",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4775830",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4775821",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM GROUP PIN",
            "identifier": "950B513500",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2008; 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.