NPIMap

Organization Active NPI

Jeremiah M. Shaft D.C. P.L.L.C.

  • Chiropractor
  • Romulus, MI
National Provider Identifier
1790731289
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008888 Issued in MI
Legal business name
JEREMIAH M. SHAFT D.C. P.L.L.C.
Practice address
9340 Wayne Rd
Suite 100
Romulus, MI 48174-1569
Phone
(734) 941-2211
Fax
(734) 941-2466
NPI assigned
May 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Jeremiah M Shaft, D.C.NPI 1053360768
Title
President
Phone
(248) 231-9650

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301008888 MI Primary

Addresses

Primary practice location

9340 Wayne Rd
Suite 100
Romulus, MI 48174-1569

Mailing address

PO Box 74126
Romulus, MI 48174-0126
Phone (734) 941-2211

Other names 1

  • True Health Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060626000023 MI Part B Supplier - Clinic/Group Practice 8527070135 Receives reassigned benefits from 3 practitioners
1 other NPI on this enrollment
Practice locations: Livonia, MI; Romulus, MI

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Jeremiah M Shaft DC PLLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

9340 Wayne Rd
Ste 100
Romulus, MI 48174
Phone (734) 941-2211

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790731289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74126",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481740126",
            "telephone_number": "734-941-2211",
            "fax_number": "734-941-2466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9340 WAYNE RD",
            "address_2": "SUITE 100",
            "city": "ROMULUS",
            "state": "MI",
            "postal_code": "481741569",
            "telephone_number": "734-941-2211",
            "fax_number": "734-941-2466"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JEREMIAH M. SHAFT D.C. P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHAFT",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-231-9650",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "True Health Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Romulus, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.