NPIMap

Organization Active NPI

Holistic Chiropractic Corp

  • Chiropractor
  • Northville, MI
National Provider Identifier
1366539504
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008561 Issued in MI
Legal business name
HOLISTIC CHIROPRACTIC CORP
Practice address
670 Griswold St Ste 200
Northville, MI 48167-2687
Phone
(248) 912-0075
NPI assigned
Oct 9, 2006
Last updated
Apr 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 30, 2021

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

Authorized official

Name
Dr. Suby Jacob Thomas, D.C.NPI 1275622151
Title
President
Phone
(248) 912-0075

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 2301008561 MI Primary

Addresses

Primary practice location

670 Griswold St Ste 200
Northville, MI 48167-2687

Mailing address

18885 Stonewater Blvd
Northville, MI 48168-8557
Phone (248) 912-0075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040303000078 MI Part B Supplier - Clinic/Group Practice 7214822170 Receives reassigned benefits from 1 practitioner
Practice locations: Northville, MI

National Provider Directory

National Provider Directory

Locations

670 Griswold St
Ste 200
Northville, MI 48167
Phone (248) 912-0075

Practitioners & affiliated clinicians

Practitioners 12

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": "1160352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619740800000",
    "number": "1366539504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18885 STONEWATER BLVD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481688557",
            "telephone_number": "248-912-0075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 GRISWOLD ST STE 200",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481672687",
            "telephone_number": "248-912-0075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLISTIC CHIROPRACTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-09",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-30",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "SUBY",
        "authorized_official_middle_name": "JACOB",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-912-0075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.