Organization Active NPI

Stedman Chiropractic Centre, P.C.

  • Chiropractor
  • Saint Louis, MI
National Provider Identifier
1659426849
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
ES005733 Issued in MI
Legal business name
STEDMAN CHIROPRACTIC CENTRE, P.C.
Practice address
1883 W Monroe Rd
Saint Louis, MI 48880-9789
Phone
(989) 681-2533
Fax
(989) 681-2533
NPI assigned
Jan 25, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Elizabeth Ann Stedman, D.C.NPI 1457346116
Title
President
Phone
(989) 681-2533

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X ES005733 MI Primary

Addresses

Primary practice location

1883 W Monroe Rd
Saint Louis, MI 48880-9789

Mailing address

1883 W Monroe Rd
Saint Louis, MI 48880-9789
Phone (989) 681-2533

Other identifiers 3

IdentifierTypeStateIssuer
0B91040OtherMIBLUE CROSS BLUE SHIELD
1008320OtherMIMCLAREN HEALTH PLAN
2849354MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130523000089 MI Part B Supplier - Clinic/Group Practice 4486892924 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Louis, MI

National Provider Directory

National Provider Directory

Locations

1883 W Monroe Rd
Saint Louis, MI 48880
Phone (989) 681-2533

Practitioners & affiliated clinicians

Practitioners 3

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": "1169683200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659426849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1883 W MONROE RD",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488809789",
            "telephone_number": "989-681-2533",
            "fax_number": "989-681-2533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1883 W MONROE RD",
            "city": "SAINT LOUIS",
            "state": "MI",
            "postal_code": "488809789",
            "telephone_number": "989-681-2533",
            "fax_number": "989-681-2533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEDMAN CHIROPRACTIC CENTRE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEDMAN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-681-2533",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "ES005733",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0B91040",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "1008320",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2849354",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.