Organization Active NPI

Lakeshore Chiropractic Center, P.C.

  • Chiropractor
  • Escanaba, MI
National Provider Identifier
1467653113
Registry record updated Sep 6, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007630 Issued in MI
Legal business name
LAKESHORE CHIROPRACTIC CENTER, P.C.
Practice address
1122 Ludington St
Escanaba, MI 49829-3540
Phone
(906) 789-7950
Fax
(906) 789-7951
NPI assigned
May 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2012

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

Authorized official

Name
Dr. Scott Edward Kwarciany, D.C.NPI 1174674428
Title
President
Phone
(906) 789-7950

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 2301007630 MI Primary

Addresses

Primary practice location

1122 Ludington St
Escanaba, MI 49829-3540

Mailing address

1122 Ludington St
Escanaba, MI 49829-3540
Phone (906) 789-7950

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120716000402 MI Part B Supplier - Clinic/Group Practice 4880850007 Receives reassigned benefits from 1 practitioner
Practice locations: Escanaba, MI

National Provider Directory

National Provider Directory

Locations

1122 Ludington St
Escanaba, MI 49829
Phone (906) 789-7950

Practitioners & affiliated clinicians

Practitioners 1

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": "1180483200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346889600000",
    "number": "1467653113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293540",
            "telephone_number": "906-789-7950",
            "fax_number": "906-789-7951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 LUDINGTON ST",
            "city": "ESCANABA",
            "state": "MI",
            "postal_code": "498293540",
            "telephone_number": "906-789-7950",
            "fax_number": "906-789-7951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-30",
        "last_updated": "2012-09-06",
        "status": "A",
        "authorized_official_last_name": "KWARCIANY",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "906-789-7950",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escanaba, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2012; 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.