Organization Active NPI

Lifestyle Chiropractic PC

  • Chiropractor
  • Temperance, MI
National Provider Identifier
1932151909
Registry record updated Jan 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008290 Issued in MI
Legal business name
LIFESTYLE CHIROPRACTIC PC
Practice address
8100 Lewis Ave
Temperance, MI 48182-1661
Phone
(734) 847-5758
Fax
(734) 847-2358
NPI assigned
May 17, 2006
Last updated
Jan 27, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2011

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

Authorized official

Name
Dr. Daryl Lee Lajiness, D.C.NPI 1114075553
Title
President
Phone
(734) 847-5758

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008290 MI Primary

Addresses

Primary practice location

8100 Lewis Ave
Temperance, MI 48182-1661

Mailing address

8100 Lewis Ave
Temperance, MI 48182-1661
Phone (734) 847-5758

Other identifiers 1

IdentifierTypeStateIssuer
4710110MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110201000241 MI Part B Supplier - Clinic/Group Practice 3072792423 Receives reassigned benefits from 2 practitioners
Practice locations: Temperance, MI

National Provider Directory

National Provider Directory

Locations

8100 Lewis Ave
Temperance, MI 48182
Phone (734) 847-5758

8100 Lewis Ave
Ste 1
Temperance, MI 48182
Phone (734) 847-5758

8100 Lewis Ave
Ste A
Temperance, MI 48182
Phone (734) 847-5758

Practitioners & affiliated clinicians

Practitioners 3

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": "1147824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296086400000",
    "number": "1932151909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8100 LEWIS AVE",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "481821661",
            "telephone_number": "734-847-5758",
            "fax_number": "734-847-2358"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8100 LEWIS AVE",
            "city": "TEMPERANCE",
            "state": "MI",
            "postal_code": "481821661",
            "telephone_number": "734-847-5758",
            "fax_number": "734-847-2358"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-17",
        "last_updated": "2011-01-27",
        "status": "A",
        "authorized_official_last_name": "LAJINESS",
        "authorized_official_first_name": "DARYL",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-847-5758",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4710110",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Temperance, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2011; 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.