Michael Dean Childs, DC – Chiropractor

Key facts

NPI: 1831667435
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 2301010723 (MI)
Practice address: 3142 Marsh Rd
Brooklyn, MI 49230-9241
Phone: (313) 461-3088
NPI assigned: Nov 13, 2018
Sex: Male
Sole proprietor: Yes

Organizations & group practices 1

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.

Origins Health Chiropractor · Saline, MI · NPI 1033681424

Medicare reassignment NPD Authorized official CHIROPRACTOR · MI

Medicare Care Compare profile

Specialty: Chiropractic
Education: Other, 2018
Medicare assignment: Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

157 Keveling Dr
Saline, MI 48176-1197
Phone (313) 461-3088

Medicare participation

Medicare fee-for-service enrollment: Enrolled in MI

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20190131003048	MI	Practitioner - Chiropractic	3678810413	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
2301010723	MI	MD	Chiropractor

Practice roles

Organization	Specialty	Status	New patients
Origins Health	Chiropractor	Current since Jan 16, 2019	Accepting new patients

Locations

157 Keveling Dr
Saline, MI 48176
Phone (313) 461-3088

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	2301010723	MI	Yes

Addresses

Primary practice location

3142 Marsh Rd
Brooklyn, MI 49230-9241

Mailing address

3142 Marsh Rd
Brooklyn, MI 49230-9241
Phone (313) 461-3088

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 13, 2018.

{
    "created_epoch": "1542067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542067200000",
    "number": "1831667435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3142 MARSH RD",
            "city": "BROOKLYN",
            "state": "MI",
            "postal_code": "492309241",
            "telephone_number": "313-461-3088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3142 MARSH RD",
            "city": "BROOKLYN",
            "state": "MI",
            "postal_code": "492309241",
            "telephone_number": "313-461-3088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHILDS",
        "first_name": "MICHAEL",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-13",
        "last_updated": "2018-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, MI

All providers in Brooklyn, MI · Chiropractor in Michigan

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 13, 2018. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.