Individual provider Active NPI

John Louis Schneider Jr., DC

  • Chiropractor
  • Southgate, MI
National Provider Identifier
1396406989
Registry record updated Jan 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301401221 Issued in MI
Practice address
15195 Allen Rd
Southgate, MI 48195-2921
Phone
(734) 284-9800
NPI assigned
Jan 5, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301401221 MI Primary

Addresses

Primary practice location

15195 Allen Rd
Southgate, MI 48195-2921

Mailing address

24734 Blanche St
Brownstown, MI 48134-9542
Phone (734) 365-2608

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220321002214 MI Practitioner - Chiropractic 9638564073 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jason J Hesselberg DC PLLCGroup PAC ID 6800040338, 3 clinicians

Practice addresses (Care Compare)

2900 Packard Rd
Suite 2
Ypsilanti, MI 48197-2061
Phone (734) 677-0111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301401221MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Jason J. Hesselberg DC PLLC Chiropractor CurrentSince Nov 8, 2022 Accepting new patients
Odette Chiropractic Family Health Center PLC Chiropractor PastSince Jan 17, 2022 Accepting new patients

Locations

2900 Packard Rd
Ste 2
Ypsilanti, MI 48197
Phone (734) 677-0111

Organizations & group practices 2

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": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1396406989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24734 BLANCHE ST",
            "city": "BROWNSTOWN",
            "state": "MI",
            "postal_code": "481349542",
            "telephone_number": "734-365-2608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15195 ALLEN RD",
            "city": "SOUTHGATE",
            "state": "MI",
            "postal_code": "481952921",
            "telephone_number": "734-284-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNEIDER",
        "first_name": "JOHN",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southgate, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.