Organization Active NPI

McLeod Shelby Chiropractic PC

  • Chiropractor
  • Shelby Township, MI
National Provider Identifier
1508191305
Registry record updated Dec 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005579 Issued in MI
Legal business name
MCLEOD SHELBY CHIROPRACTIC PC
Practice address
53505 Van Dyke Ave
Shelby Township, MI 48316-1861
Phone
(586) 992-8888
Fax
(586) 992-8889
NPI assigned
Oct 12, 2009
Last updated
Dec 9, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2010

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

Authorized official

Name
Dr. Douglas A McLeod, DCNPI 1780737619
Title
Owner
Phone
(586) 992-8888

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
Chiropractor 111N00000X 2301005579 MI Primary

Addresses

Primary practice location

53505 Van Dyke Ave
Shelby Township, MI 48316-1861

Mailing address

53505 Van Dyke Ave
Shelby Township, MI 48316-1861
Phone (586) 992-8888

Other identifiers 1

IdentifierTypeStateIssuer
950E006390OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100319000350 MI Part B Supplier - Clinic/Group Practice 8628103397 Receives reassigned benefits from 1 practitioner
Practice locations: Shelby Township, MI

National Provider Directory

National Provider Directory

Locations

53505 Van Dyke Ave
Shelby Township, MI 48316
Phone (586) 580-1752

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1255305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1291852800000",
    "number": "1508191305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "53505 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161861",
            "telephone_number": "586-992-8888",
            "fax_number": "586-992-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "53505 VAN DYKE AVE",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161861",
            "telephone_number": "586-992-8888",
            "fax_number": "586-992-8889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCLEOD SHELBY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-12",
        "last_updated": "2010-12-09",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-992-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005579",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "950E006390",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 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.