Organization Active NPI

St. Clair Chiropractic Clinic P.C.

  • Chiropractor
  • Saint Clair, MI
National Provider Identifier
1508886904
Registry record updated Jun 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005229 Issued in MI
Legal business name
ST. CLAIR CHIROPRACTIC CLINIC P.C.
Practice address
301 Trumbull St
Saint Clair, MI 48079-5339
Phone
(810) 329-9121
Fax
(810) 329-3914
NPI assigned
Jul 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2014

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

Authorized official

Name
Dr. Thomas Hanrahan, D.C.NPI 1871521534
Title
President
Phone
(810) 329-9121

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 2301005229 MI Primary

Addresses

Primary practice location

301 Trumbull St
Saint Clair, MI 48079-5339

Mailing address

301 Trumbull St
Saint Clair, MI 48079-5339
Phone (810) 329-9121

Other identifiers 1

IdentifierTypeStateIssuer
950G411230OtherMIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070105000407 MI Part B Supplier - Clinic/Group Practice 3173523636 Receives reassigned benefits from 2 practitioners
Practice locations: St Clair, MI

National Provider Directory

National Provider Directory

Locations

301 Trumbull St
Saint Clair, MI 48079
Phone (810) 329-9121

Practitioners & affiliated clinicians

Practitioners 4

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": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403827200000",
    "number": "1508886904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TRUMBULL ST",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795339",
            "telephone_number": "810-329-9121",
            "fax_number": "810-329-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 TRUMBULL ST",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795339",
            "telephone_number": "810-329-9121",
            "fax_number": "810-329-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. CLAIR CHIROPRACTIC CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2014-06-27",
        "status": "A",
        "authorized_official_last_name": "HANRAHAN",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "810-329-9121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950G411230",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2014; 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.