Organization Active NPI

Lifestyle Chiropractic Health Center

  • Chiropractor
  • Shelby Township, MI
National Provider Identifier
1790956274
Registry record updated Mar 12, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
LIFESTYLE CHIROPRACTIC HEALTH CENTER
Practice address
54820 Mound Rd
Shelby Township, MI 48316-1705
Phone
(568) 677-1616
NPI assigned
Mar 12, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2008

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

Authorized official

Name
Gina Louise Rubenstein
Title
Manager
Phone
(586) 677-1616

Specialties & licenses 1

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

Addresses

Primary practice location

54820 Mound Rd
Shelby Township, MI 48316-1705

Mailing address

54820 Mound Rd
Shelby Township, MI 48316-1705
Phone (568) 677-1616

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040910001218 MI Part B Supplier - Clinic/Group Practice 0547237471 Receives reassigned benefits from 1 practitioner
Practice locations: Shelby Township, MI

National Provider Directory

National Provider Directory

Locations

54820 Mound Rd
Shelby Township, MI 48316
Phone (568) 677-1616

Practitioners & affiliated clinicians

Practitioners 1

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": "1205280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205280000000",
    "number": "1790956274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54820 MOUND RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161705",
            "telephone_number": "568-677-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54820 MOUND RD",
            "city": "SHELBY TOWNSHIP",
            "state": "MI",
            "postal_code": "483161705",
            "telephone_number": "568-677-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE CHIROPRACTIC HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-12",
        "last_updated": "2008-03-12",
        "status": "A",
        "authorized_official_last_name": "RUBENSTEIN",
        "authorized_official_first_name": "GINA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "586-677-1616"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby Township, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.