Active NPI
Wyoming Chiropractic Health Clinic,P.C.
- Chiropractor
- Dearborn, MI
National Provider Identifier
1306901137
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301008359
- 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
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.
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4290043 | Medicaid | MI | |
| 17354 | Other | MI | GREAT LAKES HEALTH PLAN |
| 5215 | Other | MI | CAPE HEALTH PLAN |
| P98795 | Other | MI | BCN |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Chiropractor
- Dearborn, MI
- NPI 1336204247
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.