NPIMap

Organization Active NPI

Community Chiropractic Health Center, P.C.

  • Chiropractor
  • Lake Leelanau, MI
National Provider Identifier
1982966511
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301006832 Issued in MI
Legal business name
COMMUNITY CHIROPRACTIC HEALTH CENTER, P.C.
Practice address
489 W Main St
Lake Leelanau, MI 49653-9740
Phone
(231) 256-7877
Fax
(231) 256-9529
NPI assigned
Jun 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Authorized official

Name
Dr. Russell Allan Leblanc, D.C.
Title
Doctor/Owner
Phone
(231) 256-7877

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301006832 MI Primary

Addresses

Primary practice location

489 W Main St
Lake Leelanau, MI 49653-9740

Mailing address

PO Box 232
489 W Main St
Lake Leelanau, MI 49653-0232
Phone (231) 256-7877

Other identifiers 1

IdentifierTypeStateIssuer
2694706MedicaidMI

National Provider Directory

National Provider Directory

Locations

489 W Main St
Lake Leelanau, MI 49653
Phone (231) 256-7877

NPI Registry JSON

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

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339372800000",
    "number": "1982966511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232",
            "address_2": "489 W MAIN ST",
            "city": "LAKE LEELANAU",
            "state": "MI",
            "postal_code": "496530232",
            "telephone_number": "231-256-7877",
            "fax_number": "231-256-9529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "489 W MAIN ST",
            "city": "LAKE LEELANAU",
            "state": "MI",
            "postal_code": "496539740",
            "telephone_number": "231-256-7877",
            "fax_number": "231-256-9529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY CHIROPRACTIC HEALTH CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A",
        "authorized_official_last_name": "LEBLANC",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_middle_name": "ALLAN",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "231-256-7877",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006832",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2694706",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Leelanau, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2012; 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.