Organization Active NPI

Flores Chiropractic Clinic

  • Chiropractor
  • Wyandotte, MI
National Provider Identifier
1497019343
Registry record updated Jun 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
230005096 Issued in MI
Legal business name
FLORES CHIROPRACTIC CLINIC
Practice address
1642 Eureka Rd
Wyandotte, MI 48192-6104
Phone
(734) 246-5488
Fax
(734) 246-5490
NPI assigned
Jun 26, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2012

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

Authorized official

Name
Dr. Luis R Flores Jr., D.C.NPI 1588763627
Title
Chiropractor/Owner
Phone
(734) 246-5488

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 230005096 MI Primary

Addresses

Primary practice location

1642 Eureka Rd
Wyandotte, MI 48192-6104

Mailing address

1642 Eureka Rd
Wyandotte, MI 48192-6104
Phone (734) 246-5488

Other identifiers 1

IdentifierTypeStateIssuer
3028168MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20121219000219 MI Part B Supplier - Clinic/Group Practice 6305098492 Receives reassigned benefits from 1 practitioner
Practice locations: Wyandotte, MI

National Provider Directory

National Provider Directory

Locations

1642 Eureka Rd
Wyandotte, MI 48192
Phone (734) 246-5480

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": "1340668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340668800000",
    "number": "1497019343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1642 EUREKA RD",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926104",
            "telephone_number": "734-246-5488",
            "fax_number": "734-246-5490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1642 EUREKA RD",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926104",
            "telephone_number": "734-246-5488",
            "fax_number": "734-246-5490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FLORES CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-26",
        "last_updated": "2012-06-26",
        "status": "A",
        "authorized_official_last_name": "FLORES",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "734-246-5488",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "230005096",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3028168",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyandotte, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.