Organization Active NPI

Pro Chiropractic PLLC

  • Chiropractor
  • Birmingham, MI
National Provider Identifier
1881920718
Registry record updated Dec 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005895 Issued in MI
Legal business name
PRO CHIROPRACTIC PLLC
Practice address
536 N Old Woodward Ave
Birmingham, MI 48009-5375
Phone
(248) 792-9736
NPI assigned
Oct 28, 2009
Last updated
Dec 31, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2009

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

Authorized official

Name
Dr. Raymond James Hllenbrand, DC
Title
Clinic Director
Phone
(480) 284-9072

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301005895 MI Primary

Addresses

Primary practice location

536 N Old Woodward Ave
Birmingham, MI 48009-5375

Mailing address

PO Box 220
Birmingham, MI 48012-0220
Phone (480) 284-9072

Other identifiers 2

IdentifierTypeStateIssuer
95-0-F3-2959-0OtherMIBCBS
1518967298OtherAZBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20091230000439 MI Part B Supplier - Clinic/Group Practice 4486795291 Receives reassigned benefits from 1 practitioner
Practice locations: Beverly Hills, MI

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1256688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262217600000",
    "number": "1881920718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 220",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480120220",
            "telephone_number": "480-284-9072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "536 N OLD WOODWARD AVE",
            "city": "BIRMINGHAM",
            "state": "MI",
            "postal_code": "480095375",
            "telephone_number": "248-792-9736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-28",
        "last_updated": "2009-12-31",
        "status": "A",
        "authorized_official_last_name": "HLLENBRAND",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "480-284-9072",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005895",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "95-0-F3-2959-0",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1518967298",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Birmingham, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2009; 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.