Randy Joe Shallow, CHIROPRACTIC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

24820 Michigan Ave
Dearborn, MI 48124-1713

Phone

(313) 277-3766

NPI assigned

Mar 6, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Randy Joe Shallow Professional name

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College, 1979

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Shallow Chiropractic PC

  • Chiropractor
  • Dearborn, MI
  • NPI 1710988068
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1609906866",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24820 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241713",
            "telephone_number": "313-277-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24820 MICHIGAN AVE",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481241713",
            "telephone_number": "313-277-3766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHALLOW",
        "first_name": "RANDY",
        "middle_name": "JOE",
        "name_prefix": "Dr.",
        "credential": "CHIROPRACTIC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RANDY",
            "last_name": "SHALLOW",
            "middle_name": "JOE",
            "prefix": "DR.",
            "credential": "CHIROPRACTOR",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Halimeh Musaid Shajira, R.PH
• Nadeah Shajira
• Fatima Shajrah
• Shaker Haddad MD PC
• Shallow Chiropractic PC
• Adwaa Shamel
• Jenna Samer Shami
• Kifaya Shami
• Zackaria Saleh Shami
• Mahmoud Shamroukh

• Chiropractor in Dearborn, MI
• Providers in Dearborn, MI by specialty
• Chiropractor in Michigan

• 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.
• 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.