Individual provider Active NPI

Kevin Sam Choo, DC

  • Chiropractor
  • Midland, MI
National Provider Identifier
1407508971
Registry record updated Jan 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301401181 Issued in MI
Practice address
214 W Wackerly St Ste 100
Midland, MI 48640-2795
Phone
(989) 837-5998
Fax
(989) 835-9632
NPI assigned
Jan 25, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 25, 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 2301401181 MI Primary

Addresses

Primary practice location

214 W Wackerly St Ste 100
Midland, MI 48640-2795

Mailing address

214 W Wackerly St Ste 100
Midland, MI 48640-2795
Phone (989) 837-5998

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220318000619 MI Practitioner - Chiropractic 8527453067 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Triumph Chiropractic PLLCGroup PAC ID 4183925993, 2 clinicians

Practice addresses (Care Compare)

20216 Farmington Rd
Livonia, MI 48152-1412
Phone (734) 237-8916

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301401181MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Triumph Chiropractic PLLC Chiropractor CurrentSince Oct 10, 2023 Accepting new patients
Preferred Chiropractic PLLC Chiropractor CurrentSince Sep 8, 2022 Accepting new patients
Preferred Chiropractic PLLC Chiropractor PastSince Sep 8, 2022 Accepting new patients

Locations

20216 Farmington Rd
Livonia, MI 48152
Phone (248) 477-0055

3985 N Michigan Ave
Saginaw, MI 48604
Phone (989) 771-2225

Organizations & group practices 3

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": "1643068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643068800000",
    "number": "1407508971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 W WACKERLY ST STE 100",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402795",
            "telephone_number": "989-837-5998",
            "fax_number": "989-835-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 W WACKERLY ST STE 100",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486402795",
            "telephone_number": "989-837-5998",
            "fax_number": "989-835-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOO",
        "first_name": "KEVIN",
        "middle_name": "SAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-25",
        "last_updated": "2022-01-25",
        "certification_date": "2022-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 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.