Organization Active NPI

St. Johns Chiropractic Clinic, Inc.

  • Chiropractor
  • Saint Johns, MI
National Provider Identifier
1285819169
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ST. JOHNS CHIROPRACTIC CLINIC, INC.
Practice address
1004 N US Highway 27
Saint Johns, MI 48879-1129
Phone
(989) 224-8228
NPI assigned
Jan 9, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2008

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

Authorized official

Name
Dr. Rodger W MassaNPI 1992830038
Title
Owner
Phone
(989) 224-8228

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 Primary

Addresses

Primary practice location

1004 N US Highway 27
Saint Johns, MI 48879-1129

Mailing address

1004 N US Highway 27
Saint Johns, MI 48879-1129
Phone (989) 224-8228

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080417000385 MI Part B Supplier - Clinic/Group Practice 9537246475 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Johns, MI

National Provider Directory

National Provider Directory

Locations

1004 N US Highway 27
Saint Johns, MI 48879
Phone (517) 224-8228

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": "1199836800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207699200000",
    "number": "1285819169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 N US HIGHWAY 27",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488791129",
            "telephone_number": "989-224-8228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 N US HIGHWAY 27",
            "city": "SAINT JOHNS",
            "state": "MI",
            "postal_code": "488791129",
            "telephone_number": "989-224-8228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. JOHNS CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-09",
        "last_updated": "2008-04-09",
        "status": "A",
        "authorized_official_last_name": "MASSA",
        "authorized_official_first_name": "RODGER",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-224-8228",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Johns, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.