Individual provider Active NPI

Ronald Harlan Liedel Jr., D.C.

  • Radiology Chiropractor
  • Flat Rock, MI
National Provider Identifier
1619035490
Registry record updated Jun 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
License
RL005513 Issued in MI
Practice address
27375 Telegraph Rd
Flat Rock, MI 48134-1010
Phone
(734) 783-5040
Fax
(734) 783-5403
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Chiropractor 111NR0200X RL005513 MI Primary

Addresses

Primary practice location

27375 Telegraph Rd
Flat Rock, MI 48134-1010

Mailing address

27375 Telegraph Rd
Flat Rock, MI 48134-1010
Phone (734) 783-5040

Other identifiers 1

IdentifierTypeStateIssuer
3302328MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110207000607 MI Practitioner - Chiropractic 0941480032 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27375 Telegraph Rd
Flat Rock, MI 48134-1010
Phone (734) 783-5040

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RL005513MIMDRadiology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Liedel Chiropractic Clinic, Inc CurrentSince Feb 14, 1990 Accepting new patients

Locations

27375 Telegraph Rd
Flat Rock, MI 48134
Phone (734) 783-5040

27108 Telegraph Rd
Flat Rock, MI 48134
Phone (734) 783-5040

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781222400000",
    "number": "1619035490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27375 TELEGRAPH RD",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481341010",
            "telephone_number": "734-783-5040",
            "fax_number": "734-783-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27375 TELEGRAPH RD",
            "city": "FLAT ROCK",
            "state": "MI",
            "postal_code": "481341010",
            "telephone_number": "734-783-5040",
            "fax_number": "734-783-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEDEL",
        "first_name": "RONALD",
        "middle_name": "HARLAN",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2026-06-12",
        "certification_date": "2026-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "MI",
            "license": "RL005513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3302328",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flat Rock, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2026; 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.