Individual provider Active NPI

James Scott Rubenstein, DC

  • Chiropractor
  • Shelby TWP, MI
National Provider Identifier
1881708907
Registry record updated Mar 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008191 Issued in MI
Practice address
54820 Mound Rd
Shelby TWP, MI 48316-1705
Phone
(586) 677-1616
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 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 2301008191 MI Primary

Addresses

Primary practice location

54820 Mound Rd
Shelby TWP, MI 48316-1705

Mailing address

54820 Mound Rd
Shelby TWP, MI 48316-1705
Phone (586) 677-1616

Other identifiers 1

IdentifierTypeStateIssuer
950E053500OtherBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040911000167 MI Practitioner - Chiropractic 6709853633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

54820 Mound Rd
Shelby Township, MI 48316-1705
Phone (586) 677-1616

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008191MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lifestyle Chiropractic Health Center Chiropractor CurrentSince Sep 7, 2004 Accepting new patients

Locations

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332892800000",
    "number": "1881708907",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54820 MOUND RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483161705",
            "telephone_number": "586-677-1616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54820 MOUND RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483161705",
            "telephone_number": "586-677-1616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUBENSTEIN",
        "first_name": "JAMES",
        "middle_name": "SCOTT",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2012-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008191",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950E053500",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelby TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 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.