Organization Active NPI

Balanced Living Chiropractic PLLC

  • Chiropractor
  • Midland, MI
National Provider Identifier
1043402365
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008378 Issued in MI
Legal business name
BALANCED LIVING CHIROPRACTIC PLLC
Practice address
4702 James Savage Rd
Midland, MI 48642-6527
Phone
(989) 495-9003
NPI assigned
Aug 10, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Authorized official

Name
Dr. John Michael Kowalczyk, DCNPI 1043346653
Title
Manager
Phone
(248) 652-7225

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301008378 MI Primary

Addresses

Primary practice location

4702 James Savage Rd
Midland, MI 48642-6527

Mailing address

4702 James Savage Rd
Midland, MI 48642-6527
Phone (989) 495-9003

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070906000309 MI Part B Supplier - Clinic/Group Practice 6406949536 Receives reassigned benefits from 1 practitioner
Practice locations: Midland, MI; Pinconning, MI

National Provider Directory

National Provider Directory

Locations

4702 James Savage Rd
Midland, MI 48642
Phone (989) 495-9003

1000 W University Dr
Ste 2
Rochester, MI 48307
Phone (248) 652-7225

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317081600000",
    "number": "1043402365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4702 JAMES SAVAGE RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426527",
            "telephone_number": "989-495-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4702 JAMES SAVAGE RD",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486426527",
            "telephone_number": "989-495-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BALANCED LIVING CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-10",
        "last_updated": "2011-09-27",
        "status": "A",
        "authorized_official_last_name": "KOWALCZYK",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "248-652-7225",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.