Individual provider Active NPI

Chad Donald McKernan, D.C.

  • Chiropractor
  • Shelby TWP, MI
National Provider Identifier
1962622175
Registry record updated Jan 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008433 Issued in MI
Practice address
50544 Schoenherr Rd
Shelby TWP, MI 48315-3134
Phone
(586) 532-1448
Fax
(586) 532-1472
NPI assigned
Apr 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008433 MI Primary

Addresses

Primary practice location

50544 Schoenherr Rd
Shelby TWP, MI 48315-3134

Mailing address

50544 Schoenherr Rd
Shelby TWP, MI 48315-3134
Phone (586) 532-1448

Other identifiers 6

IdentifierTypeStateIssuer
2154482OtherMIFIRST HEALTH
CM008433OtherMICOMMERCIAL
P31349FOtherMIBLUE CARE NETWORK
16350OtherMIM CARE
4685500MedicaidMI
950E05407OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008433MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
McKernan Family Chiropractic Center, P.C. Chiropractor Past Accepting new patients
Hofmann Chiropractic Clinic, P.C. Chiropractor PastSince May 12, 1998 Accepting new patients

Organizations & group practices 2

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": "1177632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295308800000",
    "number": "1962622175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50544 SCHOENHERR RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483153134",
            "telephone_number": "586-532-1448",
            "fax_number": "586-532-1472"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50544 SCHOENHERR RD",
            "city": "SHELBY TWP",
            "state": "MI",
            "postal_code": "483153134",
            "telephone_number": "586-532-1448",
            "fax_number": "586-532-1472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKERNAN",
        "first_name": "CHAD",
        "middle_name": "DONALD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-27",
        "last_updated": "2011-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "2154482",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "CM008433",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "P31349F",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M CARE",
            "identifier": "16350",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4685500",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950E05407",
            "state": "MI"
        }
    ],
    "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 Jan 18, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.