Individual provider Active NPI

Michael Joseph Porter II, DC

  • Chiropractor
  • Flat Rock, MI
National Provider Identifier
1437660347
Registry record updated Oct 18, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010572 Issued in MI
Practice address
29100 Gateway Blvd Ste 100
Flat Rock, MI 48134-2764
Phone
(734) 379-9200
NPI assigned
Oct 18, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010572 MI Primary

Addresses

Primary practice location

29100 Gateway Blvd Ste 100
Flat Rock, MI 48134-2764

Mailing address

29100 Gateway Blvd Ste 100
Flat Rock, MI 48134-2764
Phone (734) 379-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171106000703 MI Practitioner - Chiropractic 7911263181 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Heidi M Labo DC PC Chiropractor CurrentSince Jul 30, 2021 Accepting new patients
Awan and Associates PC PastSince Oct 19, 2017 Accepting new patients

Locations

2300 Monroe St
Dearborn, MI 48124
Phone (313) 565-0077

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": "1508284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508284800000",
    "number": "1437660347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29100 GATEWAY BLVD STE 100",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481342764",
            "telephone_number": "734-379-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29100 GATEWAY BLVD STE 100",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481342764",
            "telephone_number": "734-379-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORTER",
        "first_name": "MICHAEL",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "II",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-18",
        "last_updated": "2017-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flat Rock, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2017; 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.