Individual provider Active NPI

Carol Elizabeth Khaznehkatbi, B.S., D.C.

  • Chiropractor
  • Mount Clemens, MI
National Provider Identifier
1982602967
Registry record updated Jan 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
8891 Issued in MI
Practice address
122 New St
Mount Clemens, MI 48043-5623
Phone
(586) 468-5381
Fax
(586) 468-9915
NPI assigned
Jul 13, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 8891 MI Primary
Chiropractor 111N00000X 2301008891 MI

Addresses

Primary practice location

122 New St
Mount Clemens, MI 48043-5623

Mailing address

122 New St
Mount Clemens, MI 48043-5623
Phone (586) 468-5381

Other identifiers 1

IdentifierTypeStateIssuer
950E016390OtherMIBLUE CROSS BLUE SHIELD

Other names 1

  • Dr. Carol E Dubbs Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050125000600 MI Practitioner - Chiropractic 8921058256 Practice locations: Mount Clemens, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

122 New St
Mount Clemens, MI 48043-5623
Phone (586) 468-5381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Bachelor of Science

State licenses

LicenseStateTypeSpecialty
2301008891MIMDChiropractor
8891MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dubbs Chiropractic Office PLLC Chiropractor CurrentSince Apr 9, 2023 Accepting new patients

Locations

122 New St
Mount Clemens, MI 48043
Phone (586) 468-5381

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": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1982602967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 NEW ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480435623",
            "telephone_number": "586-468-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 NEW ST",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480435623",
            "telephone_number": "586-468-5381",
            "fax_number": "586-468-9915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHAZNEHKATBI",
        "first_name": "CAROL",
        "middle_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "B.S., D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-07-13",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "8891",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008891",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950E016390",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROL",
            "last_name": "DUBBS",
            "middle_name": "E",
            "prefix": "DR.",
            "credential": "DC",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mount Clemens, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.