Organization Active NPI

Wyandotte Chiropractic Clinic, PLLC

  • Clinic/Center
  • Wyandotte, MI
National Provider Identifier
1578864435
Registry record updated Nov 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
2301009627 Issued in MI
Legal business name
WYANDOTTE CHIROPRACTIC CLINIC, PLLC
Practice address
866 Orchard St
Wyandotte, MI 48192-6850
Phone
(734) 284-0100
NPI assigned
Nov 9, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2010

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

Authorized official

Name
Dr. Michael Cameron, D.C.NPI 1942537055
Title
Owner/Chiropractor
Phone
(734) 740-5356

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
Clinic/Center 261Q00000X 2301009627 MI Primary

Addresses

Primary practice location

866 Orchard St
Wyandotte, MI 48192-6850

Mailing address

866 Orchard St
Wyandotte, MI 48192-6850

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101203000723 MI Part B Supplier - Clinic/Group Practice 9537356415 Receives reassigned benefits from 1 practitioner
Practice locations: Wyandotte, MI

National Provider Directory

National Provider Directory

Locations

2709 Fort St
Wyandotte, MI 48192
Phone (734) 250-9445

3217 Biddle Ave
Wyandotte, MI 48192
Phone (734) 284-0100

3138 Biddle Ave
#B
Wyandotte, MI 48192
Phone (734) 284-0100

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": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1578864435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "866 ORCHARD ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "866 ORCHARD ST",
            "city": "WYANDOTTE",
            "state": "MI",
            "postal_code": "481926850",
            "telephone_number": "734-284-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYANDOTTE CHIROPRACTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "CAMERON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "734-740-5356",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MI",
            "license": "2301009627",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 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.