NPIMap

Organization Active NPI

Medcare Inc

Doing business as Spinal Recovery Center

  • Rehabilitation Chiropractor
  • Warren, MI
National Provider Identifier
1265713242
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
2301009328 Issued in MI
Legal business name
MEDCARE INC
Doing business as
Spinal Recovery Center
Practice address
2243 E 12 Mile Rd
Warren, MI 48092-5644
Phone
(586) 573-8100
Fax
(586) 573-8101
NPI assigned
Sep 2, 2011
Last updated
Jan 28, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Authorized official

Name
John Pispidikis, DCNPI 1497708200
Title
Administrator
Phone
(586) 573-8100

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X 2301009328 MI Primary
Pain Medicine (Anesthesiology) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207LP2900X 4301093657 MI

Addresses

Primary practice location

2243 E 12 Mile Rd
Warren, MI 48092-5644

Mailing address

2243 E 12 Mile Rd
Warren, MI 48092-5644
Phone (586) 573-8100

Other names 1

  • SPINAL RECOVERY CENTER Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120405000181 MI Part B Supplier - Clinic/Group Practice 0749441442 Receives reassigned benefits from 22 practitioners
Practice locations: Warren, MI

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
23D2276258Spinal Recovery and Joint Center2243 E 12 Mile Road, Warren, MI 48092Certificate of waiverFeb 5, 2027

National Provider Directory

National Provider Directory

Locations

2243 E 12 Mile Rd
Warren, MI 48092
Phone (586) 573-8100

2243 E 12 Mile Rd
Ste 1
Warren, MI 48092

Practitioners & affiliated clinicians

Practitioners 22

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.

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1314921600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1265713242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2243 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925644",
            "telephone_number": "586-573-8100",
            "fax_number": "586-573-8101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2243 E 12 MILE RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480925644",
            "telephone_number": "586-573-8100",
            "fax_number": "586-573-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDCARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-02",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "PISPIDIKIS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "586-573-8100",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MI",
            "license": "2301009328",
            "primary": true
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "MI",
            "license": "4301093657",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SPINAL RECOVERY CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.