Individual provider Active NPI

Michael Charles Johr, D.C.

  • Chiropractor
  • Saint Clair Shores, MI
National Provider Identifier
1750326005
Registry record updated Sep 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008444 Issued in MI
Practice address
27200 Harper Ave
Suite B
Saint Clair Shores, MI 48081-1909
Phone
(586) 774-6332
Fax
(586) 774-5144
NPI assigned
Jun 19, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008444 MI Primary

Addresses

Primary practice location

27200 Harper Ave
Suite B
Saint Clair Shores, MI 48081-1909

Mailing address

27200 Harper Ave
Suite B
Saint Clair Shores, MI 48081-1909
Phone (586) 774-6332

Other identifiers 2

IdentifierTypeStateIssuer
950E016940OtherMIBLUE CROSS
3522458494OtherMICOMMERCIAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050708000163 MI Practitioner - Chiropractic 6103862503 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

27200 Harper Ave
Suite B
Saint Clair Shores, MI 48081-1909
Phone (586) 774-6332

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008444MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Johr Chiropractic Center, LLC Chiropractor CurrentSince Jan 18, 2005 Accepting new patients

Locations

27200 Harper Ave
Ste B
St Clr Shores, MI 48081
Phone (586) 774-6332

Organizations & group practices 1

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": "1150675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411689600000",
    "number": "1750326005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27200 HARPER AVE",
            "address_2": "SUITE B",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811909",
            "telephone_number": "586-774-6332",
            "fax_number": "586-774-5144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27200 HARPER AVE",
            "address_2": "SUITE B",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "480811909",
            "telephone_number": "586-774-6332",
            "fax_number": "586-774-5144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHR",
        "first_name": "MICHAEL",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-19",
        "last_updated": "2014-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "950E016940",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "3522458494",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2014; 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.