Individual provider Active NPI

Tom Sladic, DC

  • Chiropractor
  • Walled Lake, MI
National Provider Identifier
1447277884
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007531 Issued in MI
Practice address
1881 N Pontiac TRL Ste B
Walled Lake, MI 48390-3101
Phone
(248) 926-0455
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007531 MI Primary

Addresses

Primary practice location

1881 N Pontiac TRL Ste B
Walled Lake, MI 48390-3101

Mailing address

25546 Dogwood LN
Novi, MI 48374-2160
Phone (248) 444-0524

Other identifiers 1

IdentifierTypeStateIssuer
3442660MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070418000209 MI Practitioner - Chiropractic 3375648447 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2071 E W Maple Rd
Suite E 502
Commerce Township, MI 48390-3815
Phone (248) 926-0455

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Care Center Inc. Chiropractor CurrentSince Apr 1, 1998 Accepting new patients
Ozarks Medical Center Past Accepting new patients

Locations

2071 E West Maple Rd
Ste E-502
Commerce Township, MI 48390
Phone (248) 926-0455

39525 W 14 Mile Rd
Ste 100
Novi, MI 48377
Phone (248) 242-2123

1881 N Pontiac Trl
Ste B
Walled Lake, MI 48390
Phone (248) 926-0455

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": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447277884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25546 DOGWOOD LN",
            "city": "NOVI",
            "state": "MI",
            "postal_code": "483742160",
            "telephone_number": "248-444-0524"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 N PONTIAC TRL STE B",
            "city": "WALLED LAKE",
            "state": "MI",
            "postal_code": "483903101",
            "telephone_number": "248-926-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLADIC",
        "first_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007531",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3442660",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walled Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.