Individual provider Active NPI

Craig Joseph Shaeffer, D.C.

  • Chiropractor
  • Sterling Heights, MI
National Provider Identifier
1376659862
Registry record updated May 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005214 Issued in MI
Practice address
4110 17 Mile Rd
Sterling Heights, MI 48310-6880
Phone
(586) 978-0170
Fax
(586) 978-1304
NPI assigned
Aug 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301005214 MI Primary

Addresses

Primary practice location

4110 17 Mile Rd
Sterling Heights, MI 48310-6880

Mailing address

4110 17 Mile Rd
Sterling Heights, MI 48310-6880
Phone (586) 978-0170

Other identifiers 1

IdentifierTypeStateIssuer
1780111MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080327000432 MI Practitioner - Chiropractic 8123104346 Practice locations: Sterling Heights, MI

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Quantum Chiropractic and Massage PLLC Chiropractor Past 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": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685491200000",
    "number": "1376659862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4110 17 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106880",
            "telephone_number": "586-978-0170",
            "fax_number": "586-978-1304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4110 17 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483106880",
            "telephone_number": "586-978-0170",
            "fax_number": "586-978-1304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAEFFER",
        "first_name": "CRAIG",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2023-05-31",
        "certification_date": "2023-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1780111",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2023; 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.