NPIMap

Organization Active NPI

Deanda Chiropractic Clinic LLC

  • Chiropractor
  • Port Huron, MI
National Provider Identifier
1598712267
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005582 Issued in MI
Legal business name
DEANDA CHIROPRACTIC CLINIC LLC
Practice address
2887 Krafft Rd
Suite 1400
Port Huron, MI 48060
Phone
(810) 984-1994
Fax
(810) 984-3266
NPI assigned
May 28, 2006
Last updated
Feb 18, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

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

Authorized official

Name
Mr. Steven Anthony Kern, DCNPI 1528199403
Title
Owner
Phone
(810) 765-9700

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 2301005582 MI Primary

Addresses

Primary practice location

2887 Krafft Rd
Suite 1400
Port Huron, MI 48060

Mailing address

2887 Krafft Rd
Suite 1400
Port Huron, MI 48060
Phone (810) 984-1994

Other identifiers 2

IdentifierTypeStateIssuer
4776847MedicaidMI
950G410520OtherMIBCBS

National Provider Directory

National Provider Directory

Locations

2887 Krafft Rd
Ste 1000
Port Huron, MI 48060
Phone (810) 984-1994

2887 Krafft Rd
Ste 1400
Port Huron, MI 48060
Phone (810) 984-1994

Practitioners & affiliated clinicians

Practitioners 8

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": "1148774400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234915200000",
    "number": "1598712267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2887 KRAFFT RD",
            "address_2": "SUITE 1400",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-984-1994",
            "fax_number": "810-984-3266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2887 KRAFFT RD",
            "address_2": "SUITE 1400",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "48060",
            "telephone_number": "810-984-1994",
            "fax_number": "810-984-3266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEANDA CHIROPRACTIC CLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-28",
        "last_updated": "2009-02-18",
        "status": "A",
        "authorized_official_last_name": "KERN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-765-9700",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005582",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4776847",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950G410520",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Huron, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.