Organization Active NPI

Sandusky Chiropractic Center PLLC

  • Chiropractor
  • Sandusky, MI
National Provider Identifier
1518726017
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SANDUSKY CHIROPRACTIC CENTER PLLC
Practice address
418 Woodland Dr
Sandusky, MI 48471-1047
Phone
(810) 648-2820
Fax
(810) 648-4717
NPI assigned
Mar 18, 2024
Last updated
Mar 18, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
MEMPHIS FAMILY CHIROPRACTIC PLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Authorized official

Name
Nicola I Jaksa, DCNPI 1184647216
Title
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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

418 Woodland Dr
Sandusky, MI 48471-1047

Mailing address

418 Woodland Dr
Sandusky, MI 48471-1047
Phone (810) 648-2820

Other practice location 1

35040 Helze Ln
Richmond, MI 48062-2405
Phone (810) 392-7373

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240423001894 MI Part B Supplier - Clinic/Group Practice 1951740950 Receives reassigned benefits from 1 practitioner
Practice locations: Sandusky, MI

National Provider Directory

National Provider Directory
Part of
Memphis Family Chiro PLC

Locations

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

418 Woodland Dr
Sandusky, MI 48471
Phone (810) 648-2820

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

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": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1518726017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 WOODLAND DR",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711047",
            "telephone_number": "810-648-2820",
            "fax_number": "810-648-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 WOODLAND DR",
            "city": "SANDUSKY",
            "state": "MI",
            "postal_code": "484711047",
            "telephone_number": "810-648-2820",
            "fax_number": "810-648-4717"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "35040 Helze Ln",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "MI",
            "postal_code": "480622405",
            "country_code": "US",
            "telephone_number": "810-392-7373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SANDUSKY CHIROPRACTIC CENTER PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MEMPHIS FAMILY CHIROPRACTIC PLC",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-17",
        "status": "A",
        "authorized_official_last_name": "JAKSA",
        "authorized_official_first_name": "NICOLA",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-392-7373",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandusky, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2024; 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.