Individual provider Active NPI

Samuel Hage, DC

  • Chiropractor
  • Dearborn, MI
National Provider Identifier
1649773169
Registry record updated Jun 15, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010650 Issued in MI
Practice address
5452 Schaefer Rd
Dearborn, MI 48126-3223
Phone
(313) 586-3100
NPI assigned
Mar 11, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 15, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301010650 MI Primary

Addresses

Primary practice location

5452 Schaefer Rd
Dearborn, MI 48126-3223

Mailing address

19925 Vernier Rd
Ste 100
Harper Woods, MI 48225-1486

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210702000549 MI Practitioner - Chiropractic 8820499460 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Team of Michigan Chiropractor Current Accepting new patients

Locations

5452 Schaefer Rd
Dearborn, MI 48126
Phone (313) 414-8811

Organizations & group practices 2

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": "1520726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623715200000",
    "number": "1649773169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19925 VERNIER RD",
            "address_2": "STE 100",
            "city": "HARPER WOODS",
            "state": "MI",
            "postal_code": "482251486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5452 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481263223",
            "telephone_number": "313-586-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGE",
        "first_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-11",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dearborn, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.