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SHALLOW CHIROPRACTIC PC
NPI 1710988068
Chiropractor in Dearborn, MI

Active since August 09, 2005
24820 MICHIGAN AVE, DEARBORN, MI 48124(313) 277-3766(313) 277-7196 Get Directions Write a Review

NPPES record last updated: August 22, 2020. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Shallow Chiropractic Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHALLOW CHIROPRACTIC PC (NPI 1710988068) is a healthcare organization registered as a chiropractor in Dearborn, Michigan and active in the NPI registry since August 2005. The organization lists Randy Joe Shallow, President/director, as its authorized official.

NPPES Registry Identity

NPI1710988068
Entity TypeOrganization
Primary Taxonomy111N00000X
Legal Business NameSHALLOW CHIROPRACTIC PC
Location Address24820 MICHIGAN AVEDearborn, MI 48124-1713
Mailing Address24820 Michigan AveDearborn, MI 48124-1713 · (313) 277-3766 · Fax (313) 277-7196
Phone(313) 277-3766
Fax(313) 277-7196
Organization SubpartNo
Authorized OfficialRandy Joe ShallowPresident/director · (313) 277-3766
Enumeration DateAugust 9, 2005
Last NPPES UpdateAugust 22, 2020
✔ NPI 1710988068 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in MI · 2301004116
Definition
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.
24820 MICHIGAN AVE, Dearborn, MI 48124
Open in Google Maps ↗

Other Identifiers 1

OtherRS004116MI · Bcbs

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shallow Chiropractic Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Shallow Chiropractic PC, which bills Medicare for the services this clinician delivers.

Clinician (1)

Randy Shallow, CHIROPRACTIC
Chiropractic
NPI 1609906866
24820 MICHIGAN AVE
Dearborn, MI 48124
(313) 277-3766
Same address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Shallow Chiropractic PC's NPI number?

The NPI number for Shallow Chiropractic PC is 1710988068. It was assigned to this organization in the NPPES registry on August 9, 2005.

Where is Shallow Chiropractic PC located?

Shallow Chiropractic PC is located at 24820 Michigan Ave, Dearborn, MI 48124. The listed phone number is (313) 277-3766.

What is Shallow Chiropractic PC's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Shallow Chiropractic PC enrolled in Medicare?

Yes. Shallow Chiropractic PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Shallow Chiropractic PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Shallow Chiropractic PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Shallow Chiropractic PC was last updated on August 22, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.