Active NPI
Howard Bernard Shore, DC
- Chiropractor
- Southgate, MI
National Provider Identifier
1467412015
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- HS004489
- Practice address
- 13560 Northline Rd
Southgate, MI 48195 - Phone
- (734) 284-4000
- Fax
- (734) 285-0219
- NPI assigned
- Mar 27, 2006
- 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 | HS004489 | MI | Primary |
Addresses
Primary practice location
13560 Northline Rd
Southgate, MI 48195
Mailing address
13560 Northline Rd
Southgate, MI 48195
Phone (734) 284-4000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2116300 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20080716000819 | MI | Practitioner - Chiropractic | 3870666399 | Practice locations: Southgate, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Sherman College of Straight Chiropractic, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
13560 Northline Rd
Southgate, MI 48195-1080
Phone (734) 284-4000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| HS004489 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143417600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1317340800000",
"number": "1467412015",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13560 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "48195",
"telephone_number": "734-284-4000",
"fax_number": "734-285-0219"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "13560 NORTHLINE RD",
"city": "SOUTHGATE",
"state": "MI",
"postal_code": "48195",
"telephone_number": "734-284-4000",
"fax_number": "734-285-0219"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHORE",
"first_name": "HOWARD",
"middle_name": "BERNARD",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-03-27",
"last_updated": "2011-09-30",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "HS004489",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "2116300",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Southgate, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2011; 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.