Robert Scott Super, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301011062 Issued in MI

Practice address

16250 Northland Dr # 223
Southfield, MI 48075-5205

Phone

(877) 401-1440

NPI assigned

Mar 14, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Lint Chiropractic II PC

  • Chiropractor
  • Southfield, MI
  • NPI 1710693692
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647216000000",
    "number": "1447908074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX PO BOX 772813",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482770001",
            "telephone_number": "877-401-1440",
            "fax_number": "727-821-8913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16250 NORTHLAND DR # 223",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480755205",
            "telephone_number": "877-401-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUPER",
        "first_name": "ROBERT",
        "middle_name": "SCOTT",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-14",
        "last_updated": "2022-03-14",
        "certification_date": "2022-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301011062",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2301011062",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Southfield, MI
• Providers in Southfield, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.