Modern Family Chiropractic, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010048 Issued in MI

Legal business name

MODERN FAMILY CHIROPRACTIC, PLLC

Practice address

13919 19 Mile Rd
Sterling Heights, MI 48313

Phone

(586) 580-1234

NPI assigned

Jun 3, 2014

Organization subpart

No

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

Authorized official

Name

Lauren Rae Gomes, D.C.NPI 1326462870

Title

Chiropractor/Owner

Phone

(586) 580-1234

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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

• Lauren Rae Gomes, D.C

  • Chiropractor
  • Sterling Heights, MI
  • NPI 1326462870
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1401753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1861805376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13919 19 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48313",
            "telephone_number": "586-580-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13919 19 MILE RD",
            "city": "STERLING HEIGHTS",
            "state": "MI",
            "postal_code": "48313",
            "telephone_number": "586-580-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MODERN FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-03",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "GOMES",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "RAE",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "586-580-1234",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010048",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Sterling Heights, MI
• Providers in Sterling Heights, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.