Individual provider Active NPI

Ahmad Zia Khorrami, D.C.

  • Chiropractor
  • Saint Louis, MI
National Provider Identifier
1598843542
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008023 Issued in MI
Practice address
222 N Mill St
Saint Louis, MI 48880-1523
Phone
(989) 681-4107
Fax
(989) 681-3628
NPI assigned
Nov 1, 2006
Last updated
Jul 11, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008023 MI Primary

Addresses

Primary practice location

222 N Mill St
Saint Louis, MI 48880-1523

Mailing address

222 N Mill St
Saint Louis, MI 48880-1523
Phone (989) 681-4107

Other identifiers 3

IdentifierTypeStateIssuer
4967141MedicaidMI
00882OtherMIRAILROAD MEDICARE
1598843542OtherMINPI NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050301000750 MI Practitioner - Chiropractic 1850344953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 N Mill St
Saint Louis, MI 48880-1523
Phone (989) 681-4107

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Delta Chiropractic Center,P.L.L.C. Chiropractor CurrentSince Jun 17, 2002 Accepting new patients

Locations

222 N Mill St
Saint Louis, MI 48880
Phone (989) 681-4107

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1184112000000",
    "number": "1598843542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 N MILL ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801523",
            "telephone_number": "989-681-4107",
            "fax_number": "989-681-3628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 N MILL ST",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488801523",
            "telephone_number": "989-681-4107",
            "fax_number": "989-681-3628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHORRAMI",
        "first_name": "AHMAD",
        "middle_name": "ZIA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008023",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4967141",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "00882",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1598843542",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.