NPIMap

Organization Active NPI

FR Van Dyke

  • Rehabilitation Chiropractor
  • Center Line, MI
National Provider Identifier
1609111087
Registry record updated Dec 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
2301009974 Issued in MI
Legal business name
FR VAN DYKE
Doing business as
888 CRASH SOS
Practice address
24604 Van Dyke Ave
Center Line, MI 48015-1321
Phone
(586) 486-5547
Fax
(586) 486-5498
NPI assigned
Dec 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2012

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

Authorized official

Name
Adnan Mohamed
Title
Manager
Phone
(586) 770-8523

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X 2301009974 MI Primary

Addresses

Primary practice location

24604 Van Dyke Ave
Center Line, MI 48015-1321

Mailing address

24604 Van Dyke Ave
Center Line, MI 48015-1321
Phone (586) 486-5547

Other names 1

  • 888 CRASH SOS Doing business as

National Provider Directory

National Provider Directory

Locations

24604 Van Dyke Ave
Center Line, MI 48015
Phone (586) 486-5547

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": "1355184000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355184000000",
    "number": "1609111087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24604 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151321",
            "telephone_number": "586-486-5547",
            "fax_number": "586-486-5498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24604 VAN DYKE AVE",
            "city": "CENTER LINE",
            "state": "MI",
            "postal_code": "480151321",
            "telephone_number": "586-486-5547",
            "fax_number": "586-486-5498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FR VAN DYKE",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-11",
        "last_updated": "2012-12-11",
        "status": "A",
        "authorized_official_last_name": "MOHAMED",
        "authorized_official_first_name": "ADNAN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "586-770-8523"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MI",
            "license": "2301009974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "888 CRASH SOS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Center Line, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2012; 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.