Individual provider Active NPI

John Lafayette Dallas, B.SC.D.C.C.C.S.P.

  • Sports Physician Chiropractor
  • Lansing, MI
National Provider Identifier
1902835408
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
2301005663 Issued in MI
Practice address
1505 W Holmes Rd
Lansing, MI 48910-4330
Phone
(517) 882-0251
Fax
(517) 882-2724
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 2301005663 MI Primary

Addresses

Primary practice location

1505 W Holmes Rd
Lansing, MI 48910-4330

Mailing address

1505 W Holmes Rd
Lansing, MI 48910-4330
Phone (517) 882-0251

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090323000017 MI Practitioner - Chiropractic 3274690029 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1505 W Holmes Rd
Lansing, MI 48910-4330
Phone (517) 882-0251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Chiropractic Relief PLC CurrentSince Feb 13, 2009 Accepting new patients

Locations

1505 W Holmes Rd
Lansing, MI 48910
Phone (517) 882-0251

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.

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1902835408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1505 W HOLMES RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489104330",
            "telephone_number": "517-882-0251",
            "fax_number": "517-882-2724"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 W HOLMES RD",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489104330",
            "telephone_number": "517-882-0251",
            "fax_number": "517-882-2724"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALLAS",
        "first_name": "JOHN",
        "middle_name": "LAFAYETTE",
        "name_prefix": "Dr.",
        "credential": "B.SC.D.C.C.C.S.P.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MI",
            "license": "2301005663",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.