Organization Active NPI

Derek M Bowers DC PLLC

  • Medical Specialty Clinic/Center
  • Livonia, MI
National Provider Identifier
1487216123
Registry record updated Aug 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Specialty Clinic/CenterTaxonomy code 261QM2500X
Legal business name
DEREK M BOWERS DC PLLC
Practice address
13982 Merriman Rd
Livonia, MI 48154-4259
Phone
(734) 425-5454
Fax
(734) 425-8779
NPI assigned
Jul 2, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2019

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

Authorized official

Name
Margie Anne Ross
Title
Office Manager
Phone
(734) 425-5454

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X Primary

Addresses

Primary practice location

13982 Merriman Rd
Livonia, MI 48154-4259

Mailing address

13982 Merriman Rd
Livonia, MI 48154-4259
Phone (734) 425-5454

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190821000457 MI Part B Supplier - Clinic/Group Practice 4486982006 Receives reassigned benefits from 1 practitioner
Practice locations: Livonia, MI

National Provider Directory

National Provider Directory

Locations

13982 Merriman Rd
Livonia, MI 48154
Phone (734) 425-5454

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": "1562025600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566345600000",
    "number": "1487216123",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13982 MERRIMAN RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544259",
            "telephone_number": "734-425-5454",
            "fax_number": "734-425-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13982 MERRIMAN RD",
            "city": "LIVONIA",
            "state": "MI",
            "postal_code": "481544259",
            "telephone_number": "734-425-5454",
            "fax_number": "734-425-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEREK M BOWERS DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-02",
        "last_updated": "2019-08-21",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "MARGIE",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "734-425-5454"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Livonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2019; 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.