Individual provider Active NPI

Renee Michelle Smith, D.C.

  • Chiropractor
  • Shelby TWP, MI
National Provider Identifier
1336336841
Registry record updated Apr 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007759 Issued in MI
Practice address
48073 Van Dyke Ave
Shelby TWP, MI 48317-3258
Phone
(586) 739-6262
Fax
(586) 739-4540
NPI assigned
Sep 28, 2007
Sex
Female
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007759 MI Primary

Addresses

Primary practice location

48073 Van Dyke Ave
Shelby TWP, MI 48317-3258

Mailing address

48073 Van Dyke Ave
Shelby TWP, MI 48317-3258
Phone (586) 739-6262

Other identifiers 1

IdentifierTypeStateIssuer
0E02062OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2301007759MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
McLeod Chiropractic Center P.C. Chiropractor PastSince Oct 2, 2016 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1190937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207699200000",
    "number": "1336336841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "48073 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173258",
            "telephone_number": "586-739-6262",
            "fax_number": "586-739-4540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "48073 VAN DYKE AVE",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483173258",
            "telephone_number": "586-739-6262",
            "fax_number": "586-739-4540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "RENEE",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-28",
        "last_updated": "2008-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007759",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0E02062",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.