Active NPI
Martha E Pezo, DC
- Chiropractor
- Long Lake, MI
National Provider Identifier
1588672547
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MP002045
- Practice address
- 8632 Front Street
Long Lake, MI 48743 - Phone
- (989) 257-3102
- Fax
- (989) 257-3104
- NPI assigned
- Aug 4, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MP002045 | MI | Primary |
Addresses
Primary practice location
8632 Front Street
Long Lake, MI 48743
Mailing address
PO Box 2
8632 Front Street
Long Lake, MI 48743
Phone (989) 257-3102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MP002045 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588672547",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2",
"address_2": "8632 FRONT STREET",
"city": "LONG LAKE",
"state": "MI",
"postal_code": "48743",
"telephone_number": "989-257-3102",
"fax_number": "989-257-3104"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8632 FRONT STREET",
"city": "LONG LAKE",
"state": "MI",
"postal_code": "48743",
"telephone_number": "989-257-3102",
"fax_number": "989-257-3104"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEZO",
"first_name": "MARTHA",
"middle_name": "E",
"name_prefix": "Mrs.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-08-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "MP002045",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.