Individual provider Active NPI

John Nikolas Dimitriou, D.C.

  • Chiropractor
  • Farmington Hills, MI
National Provider Identifier
1770703373
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005655 Issued in MI
Practice address
38431 Grand River Ave.
Farmington Hills, MI 48335
Phone
(248) 471-7188
Fax
(248) 471-6853
NPI assigned
Apr 26, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301005655 MI Primary

Addresses

Primary practice location

38431 Grand River Ave.
Farmington Hills, MI 48335

Mailing address

38431 Grand River Ave.
Farmington Hills, MI 48335
Phone (248) 471-7188

Other identifiers 1

IdentifierTypeStateIssuer
4544397MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090119000137 MI Practitioner - Chiropractic 6800959701 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Jonathan Cromwell D.C., P.C.Group PAC ID 2163681073, 4 clinicians

Practice addresses (Care Compare)

23280 Farmington Rd
Farmington, MI 48336-3100
Phone (248) 477-1492

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Jonathan Cromwell D.C., P.C. Chiropractor CurrentSince Feb 16, 2013 Accepting new patients
North Shore Injury Center, Inc. Chiropractor Past Accepting new patients
Stoller Clinic PC Dba the Lowen Clinic Chiropractor Past Accepting new patients

Locations

23280 Farmington Rd
Farmington, MI 48336
Phone (248) 474-4484

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1770703373",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38431 GRAND RIVER AVE.",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48335",
            "telephone_number": "248-471-7188",
            "fax_number": "248-471-6853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "38431 GRAND RIVER AVE.",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "48335",
            "telephone_number": "248-471-7188",
            "fax_number": "248-471-6853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIMITRIOU",
        "first_name": "JOHN",
        "middle_name": "NIKOLAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005655",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4544397",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Farmington Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.