Organization Active NPI

Memphis Family Chiropractic PLC

  • Chiropractor
  • Richmond, MI
National Provider Identifier
1477878254
Registry record updated Apr 5, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MEMPHIS FAMILY CHIROPRACTIC PLC
Practice address
35040 Helze Lane
Richmond, MI 48062
Phone
(810) 392-7373
Fax
(810) 392-8331
NPI assigned
Apr 5, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 5, 2010

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

Authorized official

Name
Dr. Nicola Jaksa, DCNPI 1184647216
Title
Chiropractor/Owner
Phone
(810) 392-7373

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 Primary

Addresses

Primary practice location

35040 Helze Lane
Richmond, MI 48062

Mailing address

PO Box 41037
Memphis, MI 48041-1037
Phone (810) 392-7373

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101022001082 MI Part B Supplier - Clinic/Group Practice 5395938229 Receives reassigned benefits from 1 practitioner
Practice locations: Richmond, MI

National Provider Directory

National Provider Directory

Locations

35040 Helze Ln
Richmond, MI 48062
Phone (810) 392-2192

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

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": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1270425600000",
    "number": "1477878254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 41037",
            "city": "MEMPHIS",
            "state": "MI",
            "postal_code": "480411037",
            "telephone_number": "810-392-7373",
            "fax_number": "810-392-8331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35040 HELZE LANE",
            "city": "RICHMOND",
            "state": "MI",
            "postal_code": "48062",
            "telephone_number": "810-392-7373",
            "fax_number": "810-392-8331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEMPHIS FAMILY CHIROPRACTIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2010-04-05",
        "status": "A",
        "authorized_official_last_name": "JAKSA",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "810-392-7373",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2010; 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.