NPIMap

Organization Active NPI

Renaissance Chiropractic PC

  • Chiropractor
  • Burton, MI
National Provider Identifier
1306938105
Registry record updated Jul 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
RENAISSANCE CHIROPRACTIC PC
Practice address
1501 S Center Rd
Building a
Burton, MI 48509-1731
Phone
(810) 715-7746
Fax
(810) 715-7716
NPI assigned
Sep 29, 2006
Last updated
Jul 9, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2009

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

Authorized official

Name
Dr. Khaled Sayed El-Ganainy, DCNPI 1093824351
Title
Owner
Phone
(810) 715-7746

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

1501 S Center Rd
Building a
Burton, MI 48509-1731

Mailing address

1501 S Center Rd
Building a
Burton, MI 48509-1731
Phone (810) 715-7746

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040820001044 MI Part B Supplier - Clinic/Group Practice 6507830015 Receives reassigned benefits from 2 practitioners
Practice locations: Burton, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1247097600000",
    "number": "1306938105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 S CENTER RD",
            "address_2": "BUILDING A",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091731",
            "telephone_number": "810-715-7746",
            "fax_number": "810-715-7716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 S CENTER RD",
            "address_2": "BUILDING A",
            "city": "BURTON",
            "state": "MI",
            "postal_code": "485091731",
            "telephone_number": "810-715-7746",
            "fax_number": "810-715-7716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2009-07-09",
        "status": "A",
        "authorized_official_last_name": "EL-GANAINY",
        "authorized_official_first_name": "KHALED",
        "authorized_official_middle_name": "SAYED",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-715-7746",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2009; 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.