Organization Active NPI

Wyoming Chiropractic Health Clinic,P.C.

  • Chiropractor
  • Dearborn, MI
National Provider Identifier
1306901137
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008359 Issued in MI
Legal business name
WYOMING CHIROPRACTIC HEALTH CLINIC,P.C.
Practice address
7601 Wyoming St
Dearborn, MI 48126-1638
Phone
(313) 933-1256
Fax
(313) 933-2252
NPI assigned
Dec 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Hassan Mohamad Reichouni, D.C.NPI 1336204247
Title
President
Phone
(313) 933-1256

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 2301008359 MI Primary

Addresses

Primary practice location

7601 Wyoming St
Dearborn, MI 48126-1638

Mailing address

5838 Kenilworth St
Dearborn, MI 48126-2153
Phone (313) 581-5786

Other identifiers 4

IdentifierTypeStateIssuer
4290043MedicaidMI
17354OtherMIGREAT LAKES HEALTH PLAN
5215OtherMICAPE HEALTH PLAN
P98795OtherMIBCN

National Provider Directory

National Provider Directory

Locations

7601 Wyoming St
Dearborn, MI 48126
Phone (313) 933-1256

Practitioners & affiliated clinicians

Practitioners 1

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": "1166745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306901137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5838 KENILWORTH ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262153",
            "telephone_number": "313-581-5786",
            "fax_number": "313-933-2252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 WYOMING ST",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481261638",
            "telephone_number": "313-933-1256",
            "fax_number": "313-933-2252"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYOMING CHIROPRACTIC HEALTH CLINIC,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REICHOUNI",
        "authorized_official_first_name": "HASSAN",
        "authorized_official_middle_name": "MOHAMAD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-933-1256",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4290043",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES HEALTH PLAN",
            "identifier": "17354",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAPE HEALTH PLAN",
            "identifier": "5215",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCN",
            "identifier": "P98795",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.