Organization Active NPI

Shadow Chiropractic Inc

  • Chiropractor
  • Southfield, MI
National Provider Identifier
1740929256
Registry record updated Jun 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SHADOW CHIROPRACTIC INC
Practice address
23077 Greenfield Rd Ste 158
Southfield, MI 48075-3765
Phone
(248) 782-5582
NPI assigned
Jun 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2022

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

Authorized official

Name
Geoffrey Sagala, DC
Title
Member
Phone
(248) 968-9371

Specialties & licenses 1

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

Addresses

Primary practice location

23077 Greenfield Rd Ste 158
Southfield, MI 48075-3765

Mailing address

23077 Greenfield Rd Ste 158
Southfield, MI 48075-3765

National Provider Directory

National Provider Directory

Locations

23077 Greenfield Rd
Ste 158
Southfield, MI 48075
Phone (248) 782-5582

NPI Registry JSON

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

{
    "created_epoch": "1654128000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1654128000000",
    "number": "1740929256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 158",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 158",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753765",
            "telephone_number": "248-782-5582"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHADOW CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-02",
        "last_updated": "2022-06-02",
        "certification_date": "2022-06-02",
        "status": "A",
        "authorized_official_last_name": "SAGALA",
        "authorized_official_first_name": "GEOFFREY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "248-968-9371",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.