Individual provider Active NPI

Ronald Michael Boggs, DC

  • Chiropractor
  • Lathrup Village, MI
National Provider Identifier
1265416614
Registry record updated Oct 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005293 Issued in MI
Practice address
26245 Southfield Rd
Lathrup Village, MI 48076-4546
Phone
(248) 569-0366
Fax
(248) 569-5843
NPI assigned
Nov 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 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 2301005293 MI Primary

Addresses

Primary practice location

26245 Southfield Rd
Lathrup Village, MI 48076-4546

Mailing address

26245 Southfield Rd
Lathrup Village, MI 48076-4546
Phone (248) 569-0366

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071009000701 MI Practitioner - Chiropractic 7810082609 Reassigns benefits to 1 organization
Practice locations: Southfield, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cummings Chiropractic LLCGroup PAC ID 4385824184, 2 clinicians

Practice addresses (Care Compare)

477 W Nepessing St
Lapeer, MI 48446-2106
Phone (810) 664-4185

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301005293MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Cummings Chiropractic LLC Chiropractor CurrentSince Jul 29, 2017 Accepting new patients
Tariq Omar MD PC Past Accepting new patients
S. Talib Raza, P.C. PastSince Apr 1, 2007 Accepting new patients
Sacred Hope Center, Inc Past Accepting new patients

Locations

452 S Main St
Lapeer, MI 48446
Phone (810) 664-4185

477 W Nepessing St
Lapeer, MI 48446
Phone (810) 664-4185

Organizations & group practices 4

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": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191283200000",
    "number": "1265416614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26245 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764546",
            "telephone_number": "248-569-0366",
            "fax_number": "248-569-5843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26245 SOUTHFIELD RD",
            "city": "LATHRUP VILLAGE",
            "state": "MI",
            "postal_code": "480764546",
            "telephone_number": "248-569-0366",
            "fax_number": "248-569-5843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGS",
        "first_name": "RONALD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-30",
        "last_updated": "2007-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005293",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lathrup Village, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.