Individual provider Active NPI

Jack William Goss, DC

  • Chiropractor
  • Sterling Heights, MI
National Provider Identifier
1760046544
Registry record updated Apr 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010811 Issued in MI
Practice address
5600 Metropolitan Pkwy
Sterling Heights, MI 48310-4107
Phone
(586) 264-2100
NPI assigned
Apr 26, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010811 MI Primary

Addresses

Primary practice location

5600 Metropolitan Pkwy
Sterling Heights, MI 48310-4107

Mailing address

5600 Metropolitan Pkwy
Sterling Heights, MI 48310-4107
Phone (586) 264-2100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190513002157 MI Practitioner - Chiropractic 2769725894 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
William F Goss DC I PLLCGroup PAC ID 9032191887, 3 clinicians

Practice addresses (Care Compare)

5600 Metropolitan Pkwy
Sterling Heights, MI 48310-4107
Phone (810) 264-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301010811MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
William F Goss DC I PLLC Chiropractor CurrentSince May 1, 2019 Accepting new patients
William F Goss DC III PLLC Chiropractor PastSince May 1, 2019 Accepting new patients

Locations

5600 Metropolitan Pkwy
Sterling Hts, MI 48310
Phone (586) 264-2100

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1556236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1556236800000",
    "number": "1760046544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5600 METROPOLITAN PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104107",
            "telephone_number": "586-264-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5600 METROPOLITAN PKWY",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "483104107",
            "telephone_number": "586-264-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOSS",
        "first_name": "JACK",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-26",
        "last_updated": "2019-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sterling Heights, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.