NPIMap

Organization Active NPI

Lupo Chiropractic Life Center, P.C.

  • Chiropractor
  • Roseville, MI
National Provider Identifier
1750428058
Registry record updated May 7, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LUPO CHIROPRACTIC LIFE CENTER, P.C.
Practice address
27850 Gratiot Ave
Roseville, MI 48066-4803
Phone
(586) 772-5876
Fax
(586) 772-1122
NPI assigned
Jan 30, 2007
Last updated
May 7, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 7, 2014

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

Authorized official

Name
Dr. Joseph Lupo, D.C.NPI 1821154113
Title
Owner
Phone
(586) 772-5876

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MI Primary
Physical Therapist 225100000X MI
Massage Therapist 225700000X MI

Addresses

Primary practice location

27850 Gratiot Ave
Roseville, MI 48066-4803

Mailing address

27850 Gratiot Ave
Roseville, MI 48066-4803
Phone (586) 772-5876

Other identifiers 1

IdentifierTypeStateIssuer
950E001220OtherMIBCBS MI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040721000855 MI Part B Supplier - Clinic/Group Practice 8921088931 Receives reassigned benefits from 12 practitioners
Practice locations: Roseville, MI

National Provider Directory

National Provider Directory

Locations

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

27882 Gratiot Ave
Roseville, MI 48066
Phone (313) 729-6216

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1399420800000",
    "number": "1750428058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27850 GRATIOT AVE",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664803",
            "telephone_number": "586-772-5876",
            "fax_number": "586-772-1122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27850 GRATIOT AVE",
            "city": "ROSEVILLE",
            "state": "MI",
            "postal_code": "480664803",
            "telephone_number": "586-772-5876",
            "fax_number": "586-772-1122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LUPO CHIROPRACTIC LIFE CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-05-07",
        "status": "A",
        "authorized_official_last_name": "LUPO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-772-5876",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": null,
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MI",
            "identifier": "950E001220",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roseville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2014; 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.