Individual provider Active NPI

Brian Anthony Scolari, D.C.

  • Chiropractor
  • Shelby Township, MI
National Provider Identifier
1366447245
Registry record updated Dec 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008199 Issued in MI
Practice address
54989 Shelby Rd
Shelby Township, MI 48316-1448
Phone
(248) 656-7194
Fax
(248) 656-7195
NPI assigned
Jun 16, 2005
Reactivated
Mar 23, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008199 MI Primary

Addresses

Primary practice location

54989 Shelby Rd
Shelby Township, MI 48316-1448

Mailing address

54989 Shelby Rd
Shelby Township, MI 48316-1448
Phone (248) 656-7194

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040710000361 MI Practitioner - Chiropractic 0244218790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Specific Chiropractic IncGroup PAC ID 7618955162, 2 clinicians

Practice addresses (Care Compare)

54989 Shelby Rd
Shelby Township, MI 48316-1448
Phone (248) 656-7194

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008199MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Specific Chiropractic Inc. Chiropractor CurrentSince Sep 1, 2000 Accepting new patients

Locations

54989 Shelby Rd
Shelby Township, MI 48316
Phone (248) 656-7194

54989 Shelby Rd
Ste A
Shelby Township, MI 48316

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": "1118880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1355270400000",
    "number": "1366447245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54989 SHELBY RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161448",
            "telephone_number": "248-656-7194",
            "fax_number": "248-656-7195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54989 SHELBY RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161448",
            "telephone_number": "248-656-7194",
            "fax_number": "248-656-7195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOLARI",
        "first_name": "BRIAN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-12-12",
        "deactivation_date": "2006-03-18",
        "reactivation_date": "2006-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008199",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.