Organization Active NPI

Performance Health Chiropractic PLC

  • Chiropractor
  • Ann Arbor, MI
National Provider Identifier
1710295910
Registry record updated Sep 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009501 Issued in MI
Legal business name
PERFORMANCE HEALTH CHIROPRACTIC PLC
Practice address
2330 E Stadium Blvd
Suite 3
Ann Arbor, MI 48104-4820
Phone
(734) 929-4523
NPI assigned
Sep 22, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2010

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

Authorized official

Name
Dr. Timothy Dehr, DCNPI 1922243781
Title
Owner
Phone
(734) 929-4523

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 2301009501 MI Primary

Addresses

Primary practice location

2330 E Stadium Blvd
Suite 3
Ann Arbor, MI 48104-4820

Mailing address

2330 E Stadium Blvd
Suite 3
Ann Arbor, MI 48104-4820
Phone (734) 929-4523

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110525000613 MI Part B Supplier - Clinic/Group Practice 9032395199 Receives reassigned benefits from 1 practitioner
Practice locations: Ann Arbor, MI

National Provider Directory

National Provider Directory

Locations

2330 E Stadium Blvd
Ste 3
Ann Arbor, MI 48104
Phone (734) 330-7787

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285113600000",
    "number": "1710295910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 E STADIUM BLVD",
            "address_2": "SUITE 3",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044820",
            "telephone_number": "734-929-4523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 E STADIUM BLVD",
            "address_2": "SUITE 3",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481044820",
            "telephone_number": "734-929-4523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE HEALTH CHIROPRACTIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-09-22",
        "last_updated": "2010-09-22",
        "status": "A",
        "authorized_official_last_name": "DEHR",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-929-4523",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2010; 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.