Organization Active NPI

Thrive Chiropractic Dexter P.C.

  • Chiropractor
  • Dexter, MI
National Provider Identifier
1639317514
Registry record updated Oct 25, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
THRIVE CHIROPRACTIC DEXTER P.C.
Practice address
3219 Broad St
Suite 106
Dexter, MI 48130
Phone
(734) 253-2114
NPI assigned
Jan 30, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2017

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

Authorized official

Name
Dr. Jennifer Simpson, D.C.NPI 1316097876
Title
Owner
Phone
(734) 253-2114

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Preferred Provider Organization 305R00000X 2301008768 MI

Addresses

Primary practice location

3219 Broad St
Suite 106
Dexter, MI 48130

Mailing address

3219 Broad St.
Suite 106
Dexter, MI 48130
Phone (734) 253-2114

Other identifiers 1

IdentifierTypeStateIssuer
MI2698OtherMIPTAN

Other names 2

  • Simpson Family Chiropractic Former legal business name
  • Simpson Family Chiropractic PC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100505000740 MI Part B Supplier - Clinic/Group Practice 5294863601 Receives reassigned benefits from 2 practitioners
Practice locations: Dexter, MI

National Provider Directory

National Provider Directory

Locations

3219 Broad St
Ste 106
Dexter, MI 48130
Phone (734) 253-2114

Practitioners & affiliated clinicians

Practitioners 2

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": "1233273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1508889600000",
    "number": "1639317514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3219 BROAD ST.",
            "address_2": "SUITE 106",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "48130",
            "telephone_number": "734-253-2114",
            "fax_number": "734-253-2132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3219 BROAD ST",
            "address_2": "SUITE 106",
            "city": "DEXTER",
            "state": "MI",
            "postal_code": "48130",
            "telephone_number": "734-253-2114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THRIVE CHIROPRACTIC DEXTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-30",
        "last_updated": "2017-10-25",
        "status": "A",
        "authorized_official_last_name": "SIMPSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-253-2114",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "MI",
            "license": "2301008768",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "MI2698",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Simpson Family Chiropractic",
            "code": "4",
            "type": "Former Legal Business Name"
        },
        {
            "organization_name": "Simpson Family Chiropractic PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Dexter, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.