Active NPI
Ricky Otto Schelter, DC
- Chiropractor
- Davison, MI
National Provider Identifier
1902969199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 005260
- Practice address
- 3058 N State Rd Unit D
Davison Chiropractic
Davison, MI 48423 - Phone
- (810) 658-3383
- Fax
- (810) 653-4425
- NPI assigned
- Dec 18, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 005260 | MI | Primary |
Addresses
Primary practice location
3058 N State Rd Unit D
Davison Chiropractic
Davison, MI 48423
Mailing address
3058 N State Rd Unit D
Davison, MI 48423
Phone (810) 658-3383
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| OB51216 | Other | MI | BLUE CROSS |
| 187201714 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110120000919 | MI | Practitioner - Chiropractic | 4688853856 | Practice locations: Davison, MI |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Sherman College of Straight Chiropractic, 1985
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
3058 N State Rd Unit D
Davison, MI 48423-3508
Phone (810) 658-3383
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 005260 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166400000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1279670400000",
"number": "1902969199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3058 N STATE RD UNIT D",
"city": "DAVISON",
"state": "MI",
"postal_code": "48423",
"telephone_number": "810-658-3383",
"fax_number": "810-653-4425"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3058 N STATE RD UNIT D",
"address_2": "DAVISON CHIROPRACTIC",
"city": "DAVISON",
"state": "MI",
"postal_code": "48423",
"telephone_number": "810-658-3383",
"fax_number": "810-653-4425"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHELTER",
"first_name": "RICKY",
"middle_name": "OTTO",
"name_prefix": "Mr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-18",
"last_updated": "2010-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "005260",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS",
"identifier": "OB51216",
"state": "MI"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "187201714",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}Other providers in Davison, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2010; 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.