Active NPI
Philip George Berent, D.C.
- Chiropractor
- Port Sanilac, MI
National Provider Identifier
1457571499
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301004763
- Practice address
- 125 Saint Mary Dr
Port Sanilac, MI 48469-9656 - Phone
- (810) 622-8202
- NPI assigned
- May 1, 2007
- 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 | 2301004763 | MI | Primary |
Addresses
Primary practice location
125 Saint Mary Dr
Port Sanilac, MI 48469-9656
Mailing address
3850 McKinley St
Dearborn, MI 48124-3674
Phone (313) 562-4919
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11271830 | Other | MI | (CAQH) |
| 950G6511 | Other | MI | BLUE CROSS BLUE SHIELD |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1457571499",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3850 MCKINLEY ST",
"city": "DEARBORN",
"state": "MI",
"postal_code": "481243674",
"telephone_number": "313-562-4919"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "125 SAINT MARY DR",
"city": "PORT SANILAC",
"state": "MI",
"postal_code": "484699656",
"telephone_number": "810-622-8202"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BERENT",
"first_name": "PHILIP",
"middle_name": "GEORGE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301004763",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "(CAQH)",
"identifier": "11271830",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "950G6511",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Port Sanilac, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.