Organization Active NPI

Alternative Healing Chiropractic Center, PLLC

  • Chiropractor
  • Wixom, MI
National Provider Identifier
1396141982
Registry record updated Feb 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010239 Issued in MI
Legal business name
ALTERNATIVE HEALING CHIROPRACTIC CENTER, PLLC
Practice address
49100 Pontiac TRL
Wixom, MI 48393-2569
Phone
(248) 669-1109
Fax
(248) 669-2552
NPI assigned
Nov 10, 2014
Last updated
Feb 10, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2016

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

Authorized official

Name
Dr. David Philip Gavron, D.C.NPI 1083021208
Title
Sole Member
Phone
(248) 669-1109

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 2301010239 MI Primary

Addresses

Primary practice location

49100 Pontiac TRL
Wixom, MI 48393-2569

Mailing address

49100 Pontiac TRL
Wixom, MI 48393-2569
Phone (248) 669-1109

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150624001853 MI Part B Supplier - Clinic/Group Practice 4688985120 Receives reassigned benefits from 1 practitioner
Practice locations: Wixom, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1415577600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1455062400000",
    "number": "1396141982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49100 PONTIAC TRL",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483932569",
            "telephone_number": "248-669-1109",
            "fax_number": "248-669-2552"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49100 PONTIAC TRL",
            "city": "WIXOM",
            "state": "MI",
            "postal_code": "483932569",
            "telephone_number": "248-669-1109",
            "fax_number": "248-669-2552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALTERNATIVE HEALING CHIROPRACTIC CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-10",
        "last_updated": "2016-02-10",
        "status": "A",
        "authorized_official_last_name": "GAVRON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "PHILIP",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "248-669-1109",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010239",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wixom, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2016; 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.