NPI 1134549553: DANIEL J THOMAS DC

DANIEL J THOMAS DC

Chiropractor in EAST JORDAN - Michigan

Status: Active (Since 04/24/2014) Npi: 1134549553

Information about DANIEL J THOMAS DC

DANIEL J THOMAS DC is a provider established in EAST JORDAN, Michigan. The practitioners primary taxonomy code is: 111N00000X with license number: 2301004661 MI . The NPI number of DANIEL J THOMAS DC is 1134549553 and was assigned on 04/24/2014.

Other organization name: LAKESIDE CHIROPRACTIC. Name type code: 3 - doing business as (d/b/ a) name.


Mailing address
CityEAST JORDAN
Postalcode497279301
StateMI
Telephone Number2315362616
Address101 BRIDGE ST
Address #2PO BOX 602
Primary practice address
CityEAST JORDAN
Postalcode497279301
StateMichigan
Phone2315362616
Address101 BRIDGE ST
NPI1134549553
Provider Enumeration Date04/24/2014
Last Updated04/24/2014
Authorized official
NameDR. DANIEL JAMES THOMAS
Telephone Number2315362616
Title or positionOWNER
CredentialsDC

Detailed Information

NPI Number 1134549553 has the "Organization". Type of ownership and has been registered to the following primary business legal name (which is a provider name or healthcare organization name) — LAKESIDE CHIROPRACTIC. Name type code: 3 - doing business as (d/b/ a) name. The enumeration date of this NPI Number is 04/24/2014. NPI Number information was last updated on 04/24/2014.

DANIEL J THOMAS DC - provider taxonomy: Chiropractor

Primary taxonomy (there can be only one per NPI record).
Taxonomy group193400000X SINGLE SPECIALTY GROUP.
License number2301004661
License stateMI
Taxonomy code 111N00000X

Taxonomy description:

A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

Additional identifiers

  • Identifier: 1609934
  • Code / Type: 5 - MEDICAID
  • Identifier state : MI

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
NPI1134549553
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1111N00000X
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Provider Enumeration Date04/24/2014
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated04/24/2014
The date that a record was last updated or changed.
Entity TypeOrganization
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Organization SubpartN
The "Is the organization a subpart?" question must be answered. If the organization is a subpart, the Parent Organization Legal Business Name (LBN) and Parent Organization Taxpayer Identification Number (TIN) fields must be completed. The Parent Organization LBN and TIN fields can only be completed if the answer to the subpart question is Yes. Many organization health care providers who apply for NPIs are not legal entities themselves but are parts of other organization health care providers that are legal entities (the "parents"). Here are three examples of organization health care providers that may be considered subparts and may apply for NPIs if so directed by their "parents": (1) The psychiatric unit in a hospital is not a legal entity but is part of the hospital (the "parent"), which is a legal entity. The legal entity must obtain an NPI. The psychiatric unit is an example of a subpart that could have its own NPI if the hospital determines that it should. (2) A group practice that is not a sole proprietorship has a main location and could have other offices in different locations, but each office is not a separate legal entity; instead, each office is part of the corporation (the "parent") which is a legal entity. The offices are examples of subparts that could have their own NPIs if the main location determines that they should. (3) A pharmacy fills prescriptions for patients whose physicians have prescribed medications for them and may also rent or sell durable medical equipment to patients whose physicians have ordered such equipment for them. Neither the pharmacy line of business nor the DME line of business represent legal entities; instead, both lines of business are part of an organization (the "parent") that is a legal entity. Each line of business represents a different Healthcare Provider Taxonomy or area of specialization that often submits its own electronic claims to health plans. The "parent"-we don"t know who the parent is in this example-must ensure that each subpart that submits its own claims to health plans has its own NPI.
Provider Organization Name (Legal Business Name)DANIEL J THOMAS DC
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider Other Organization NameLAKESIDE CHIROPRACTIC
Other name by which the organization provider is or has been known.
Provider Other Organization Name Type Code3
Code identifying the type of other name. Codes are: 1 = former name; 2 = professional name; 3 = doing business as (d/b/a) name; 4 = former legal business name; 5 = other.
Provider First Line Business Mailing Address101 BRIDGE ST
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Second Line Business Mailing AddressPO BOX 602
The second line mailing address of the provider being identified. This data element may contain the same information as "Provider second line location address".
Provider Business Mailing Address City NameEAST JORDAN
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameMI
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code497279301
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2315362616
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Provider First Line Business Practice Location Address101 BRIDGE ST
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameEAST JORDAN
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameMichigan
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code497279301
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2315362616
The telephone number associated with the location address of the provider being identified.
Authorized Official Last NameTHOMAS
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First NameDANIEL
The first name of the authorized official
Authorized Official Middle NameJAMES
The middle name of the authorized official
Authorized Official Title or PositionOWNER
The title or position of the authorized official
Authorized Official Name Prefix TextDR.
Authorized Official Name Prefix Text
Authorized Official Credential TextDC
Authorized Official Credential Text
Authorized Official Telephone Number2315362616
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code #1111N00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1Chiropractor
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
Provider License Number 12301004661
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1MI
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Other Provider Identifier 11609934
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1MI
Other Provider Identifier State #1
X

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