Organization Active NPI

Michigan Spine Management Clinic PLC

  • Chiropractor
  • Dearborn, MI
National Provider Identifier
1457763773
Registry record updated May 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010126 Issued in MI
Legal business name
MICHIGAN SPINE MANAGEMENT CLINIC PLC
Practice address
444 N Telegraph Rd
Dearborn, MI 48128-1619
Phone
(313) 406-6002
Fax
(313) 406-6484
NPI assigned
May 21, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2025

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

Authorized official

Name
Dr. Mohamed Jamal Raychouni, D.C.NPI 1679995401
Title
Owner
Phone
(313) 406-6002

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301010126 MI Primary

Addresses

Primary practice location

444 N Telegraph Rd
Dearborn, MI 48128-1619

Mailing address

444 N Telegraph Rd
Dearborn, MI 48128-1619
Phone (313) 406-6002

Other names 1

  • michigan spine management Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140617000650 MI Part B Supplier - Clinic/Group Practice 5193949022 Receives reassigned benefits from 3 practitioners
Practice locations: Dearborn Heights, MI

National Provider Directory

National Provider Directory

Locations

444 N Telegraph Rd
Dearborn, MI 48128
Phone (313) 406-6002

22350 Ford Rd
Dearborn Heights, MI 48127
Phone (313) 278-2788

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1400630400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747353600000",
    "number": "1457763773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "444 N TELEGRAPH RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281619",
            "telephone_number": "313-406-6002",
            "fax_number": "313-406-6484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 N TELEGRAPH RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481281619",
            "telephone_number": "313-406-6002",
            "fax_number": "313-406-6484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHIGAN SPINE MANAGEMENT CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-21",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A",
        "authorized_official_last_name": "RAYCHOUNI",
        "authorized_official_first_name": "MOHAMED",
        "authorized_official_middle_name": "JAMAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-406-6002",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010126",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "michigan spine management",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "michigan spine management",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2025; 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.