Active NPI
Michael R. Izquierdo, D.C.
- Chiropractor
- Lakewood, OH
National Provider Identifier
1407944663
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 3664
- Practice address
- 14524 Detroit Ave
Lakewood, OH 44107-4317 - Phone
- (216) 521-7777
- Fax
- (216) 521-7778
- NPI assigned
- Oct 11, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 3664 | OH | Primary |
Addresses
Primary practice location
14524 Detroit Ave
Lakewood, OH 44107-4317
Mailing address
14524 Detroit Ave
Lakewood, OH 44107-4317
Phone (216) 521-7777
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3664 | OH | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160524800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1193184000000",
"number": "1407944663",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14524 DETROIT AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441074317",
"telephone_number": "216-521-7777",
"fax_number": "216-521-7778"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14524 DETROIT AVE",
"city": "LAKEWOOD",
"state": "OH",
"postal_code": "441074317",
"telephone_number": "216-521-7777",
"fax_number": "216-521-7778"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IZQUIERDO",
"first_name": "MICHAEL",
"middle_name": "R.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-11",
"last_updated": "2007-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "3664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lakewood, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.