Individual provider Active NPI

Stephen Michael Vallecorse, D.C.

  • Chiropractor
  • Rochester, MI
National Provider Identifier
1851636955
Registry record updated Dec 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010018 Issued in MI
Practice address
117 W 4TH St
Rochester, MI 48307-2025
Phone
(248) 841-1785
Fax
(248) 841-1894
NPI assigned
Dec 1, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010018 MI Primary

Addresses

Primary practice location

117 W 4TH St
Rochester, MI 48307-2025

Mailing address

117 W 4TH St
Rochester, MI 48307-2025
Phone (248) 841-1785

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20130617000326 MI Practitioner - Chiropractic 3476792821 Reassigns benefits to 2 organizations
I20260618000925 FL Practitioner - Chiropractic 3476792821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2012
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

877 S Orange Blossom TRL
Apopka, FL 32703-6522

PO Box
Chattanooga, TN 37422

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Odette Chiropractic Family Health Center PLC Chiropractor CurrentSince Dec 3, 2024 Accepting new patients
Medcare Inc CurrentSince Aug 1, 2025 Accepting new patients

Locations

20960 Allen Rd
Brownstown Twp, MI 48183
Phone (734) 479-5130

2243 E 12 Mile Rd
Warren, MI 48092
Phone (586) 573-8100

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1354320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354320000000",
    "number": "1851636955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 W 4TH ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072025",
            "telephone_number": "248-841-1785",
            "fax_number": "248-841-1894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 W 4TH ST",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483072025",
            "telephone_number": "248-841-1785",
            "fax_number": "248-841-1894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VALLECORSE",
        "first_name": "STEPHEN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-12-01",
        "last_updated": "2012-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rochester, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2012; 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.