Organization Active NPI

Aim Dynamic Healthcare PLLC

  • Multi-Specialty Clinic/Center
  • Clinton Township, MI
National Provider Identifier
1770314619
Registry record updated Aug 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
AIM DYNAMIC HEALTHCARE PLLC
Practice address
21360 Cass Ave
Clinton Township, MI 48036-1482
Phone
(586) 468-6868
NPI assigned
Aug 12, 2024
Last updated
Aug 12, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2024

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

Authorized official

Name
David McFaddenNPI 1720287410
Title
Owner
Phone
(586) 206-1463

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU
Multi-Specialty Clinic/Center 261QM1300X NU Primary

Addresses

Primary practice location

21360 Cass Ave
Clinton Township, MI 48036-1482

Mailing address

21360 Cass Ave
Clinton Township, MI 48036-1482

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241231000589 MI Part B Supplier - Clinic/Group Practice 1153858279 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Clemens, MI; Clinton Township, MI

National Provider Directory

National Provider Directory

Locations

1430 Gratiot Ave
Mount Clemens, MI 48043

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1723420800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723420800000",
    "number": "1770314619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21360 CASS AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480361482"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21360 CASS AVE",
            "city": "CLINTON TOWNSHIP",
            "state": "MI",
            "postal_code": "480361482",
            "telephone_number": "586-468-6868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AIM DYNAMIC HEALTHCARE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-12",
        "last_updated": "2024-08-12",
        "certification_date": "2024-08-12",
        "status": "A",
        "authorized_official_last_name": "MCFADDEN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-206-1463"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2024; 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.