Advanced Care Chiropractic PC
Organization Active NPI Chiropractor · Holly, MI
NPI 1306038732 · NPPES record last updated Nov 28, 2012
Key facts
- NPI
- 1306038732
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- JW008827 (MI)
- Legal business name
- ADVANCED CARE CHIROPRACTIC PC
- Practice address
- 1016 N Saginaw St
Suite C
Holly, MI 48442-1351 - Phone
- (248) 328-9800
- Fax
- (248) 328-9801
- NPI assigned
- Aug 9, 2007
- Organization subpart
- No
Authorized official
- Name
- Mrs. Misty White, D.C.
- Title
- Owner
- Phone
- (248) 328-9800
Other NPIs on the same Medicare enrollment 1
Corporate family (same tax ID) 1
Practitioners 3
-
Jason Mathieu White, D.C.
-
Jarrod Wayne Bailey, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050412001015 | MI | Part B Supplier - Clinic/Group Practice | 3173560059 |
Receives reassigned benefits from 3 practitioners 1 other NPI on this enrollment Practice locations: Holly, MI; Fenton, MI |
National Provider Directory
- Tax ID family
- Advanced Care Chiro PC
Locations
1016 N Saginaw St
Ste C
Holly, MI 48442
Phone (248) 328-9800
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | JW008827 | MI | Yes |
Addresses
Primary practice location
1016 N Saginaw St
Suite C
Holly, MI 48442-1351
Mailing address
1016 N Saginaw St
Suite C
Holly, MI 48442-1351
Phone (248) 328-9800
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144804567 | Medicaid | MI |
Other providers in Holly, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 28, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.