Individual provider Active NPI

Paul Jeremy McAllister, D.C.

  • Chiropractor
  • Lansing, MI
National Provider Identifier
1023490687
Registry record updated Jun 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010307 Issued in MI
Practice address
1717 E Michigan Ave
Suite a
Lansing, MI 48912-2840
Phone
(517) 253-8360
Fax
(517) 253-8393
NPI assigned
Jun 19, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010307 MI Primary

Addresses

Primary practice location

1717 E Michigan Ave
Suite a
Lansing, MI 48912-2840

Mailing address

1717 E Michigan Ave
Suite a
Lansing, MI 48912-2840
Phone (517) 253-8360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151009000608 MI Practitioner - Chiropractic 3072821123 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2014
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

2627 E Beltline Ave SE
Suite 110
Grand Rapids, MI 49546-5937
Phone (616) 365-5251

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kentwood Family Chiropractic, LLC Chiropractor CurrentSince Nov 6, 2023 Accepting new patients

Locations

2627 E Beltline Ave SE
Ste 110
Grand Rapids, MI 49546
Phone (563) 639-0221

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/21411/brand/1/csg/1/fhir/r4

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": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1023490687",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 E MICHIGAN AVE",
            "address_2": "SUITE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122840",
            "telephone_number": "517-253-8360",
            "fax_number": "517-253-8393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 E MICHIGAN AVE",
            "address_2": "SUITE A",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489122840",
            "telephone_number": "517-253-8360",
            "fax_number": "517-253-8393"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCALLISTER",
        "first_name": "PAUL",
        "middle_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2015; 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.