Individual provider Active NPI

Shawn Jonathan Wrubel, D.C.

  • Chiropractor
  • Ferndale, MI
National Provider Identifier
1689933798
Registry record updated Jul 31, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009873 Issued in MI
Practice address
811 Livernois St
Ferndale, MI 48220-2308
Phone
(248) 439-1017
Fax
(248) 439-1017
NPI assigned
May 9, 2012
Last updated
Jul 31, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009873 MI Primary

Addresses

Primary practice location

811 Livernois St
Ferndale, MI 48220-2308

Mailing address

811 Livernois St
Ferndale, MI 48220-2308
Phone (248) 439-1017

Other identifiers 1

IdentifierTypeStateIssuer
2301009873OtherMISTATE CHIROPRACTIC LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120814000328 MI Practitioner - Chiropractic 0244486892 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

811 Livernois St
Ferndale, MI 48220-2308
Phone (586) 329-6730

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shawn J Wrubel, D.C PLC Chiropractor CurrentSince Aug 27, 2020 Accepting new patients
Lupo Chiropractic Life Center, P.C. Chiropractor CurrentSince Apr 1, 2018 Accepting new patients

Locations

811 Livernois St
Ferndale, MI 48220
Phone (248) 439-1017

27850 Gratiot Ave
Roseville, MI 48066
Phone (586) 772-3800

Interoperability endpoints

  • Direct secure messaging: swrubel620631@direct.hfhs.org

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596153600000",
    "number": "1689933798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 LIVERNOIS ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202308",
            "telephone_number": "248-439-1017",
            "fax_number": "248-439-1017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 LIVERNOIS ST",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "482202308",
            "telephone_number": "248-439-1017",
            "fax_number": "248-439-1017"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WRUBEL",
        "first_name": "SHAWN",
        "middle_name": "JONATHAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2020-07-31",
        "certification_date": "2020-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009873",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE CHIROPRACTIC LICENSE",
            "identifier": "2301009873",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ferndale, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; 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.