Stephan John Smith, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301007830 Issued in MI

Practice address

11319 South Saginaw Street
Grand Blanc, MI 48439-1268

Phone

(810) 694-2200

Fax

(810) 694-6750

NPI assigned

Sep 29, 2006

Sex

Male

Sole proprietor

No

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.

• Dr. Adam N Rushford DC PLLC

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  MI

  Medicare reassignment Care Compare group
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• GCC Chiropractic of Grand Blanc PLC

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  NPD (past)
• Gennero Chiropractic Health Center PC

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  • NPI 1780898486
  NPD (past)
• Gischia Healthsource PLLC

  • Chiropractor
  • Highland, MI
  • NPI 1497535314
  NPD (past)

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dr Adam N Rushford DC PLLC 3 clinicians

Practice addresses (Care Compare)

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1821180266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11319 SOUTH SAGINAW STREET",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391268",
            "telephone_number": "810-694-2200",
            "fax_number": "810-694-6750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11319 SOUTH SAGINAW STREET",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484391268",
            "telephone_number": "810-694-2200",
            "fax_number": "810-694-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STEPHAN",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007830",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD CARRIER",
            "identifier": "P00009050",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "01006003",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH ADVA",
            "identifier": "1006672",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard Smith, D.O.
• Rylee Smith
• Scott Smith, D.D.S.
• Shantangelia Smith
• Shaquille M Smith
• Talea Smith
• Amanda Snow
• Jeffrey Sobecki
• Mohammed Jehad Sobh Sr., MD
• Elizabeth Susan Sobol, PHARMACY TECHNICIAN

• All providers in Grand Blanc, MI
• Chiropractor in Michigan

• 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.