Organization Active NPI

Bright Life Family Chiropractic, PLLC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1063826071
Registry record updated Jun 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010127 Issued in MI
Legal business name
BRIGHT LIFE FAMILY CHIROPRACTIC, PLLC
Practice address
3097 29TH St SE
Grand Rapids, MI 49512-1726
Phone
(616) 710-4106
Fax
(616) 710-4117
NPI assigned
Jun 17, 2014
Last updated
Jun 17, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2014

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

Authorized official

Name
Dr. Erica N Anderson, D.C
Title
Ceo
Phone
(616) 710-4106

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010127 MI Primary

Addresses

Primary practice location

3097 29TH St SE
Grand Rapids, MI 49512-1726

Mailing address

3097 29TH St SE
Grand Rapids, MI 49512-1726
Phone (616) 710-4106

National Provider Directory

National Provider Directory

Locations

3097 29th St SE
Grand Rapids, MI 49512
Phone (616) 741-2232

NPI Registry JSON

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

{
    "created_epoch": "1402963200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1063826071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3097 29TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121726",
            "telephone_number": "616-710-4106",
            "fax_number": "616-710-4117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3097 29TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121726",
            "telephone_number": "616-710-4106",
            "fax_number": "616-710-4117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHT LIFE FAMILY CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-17",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-710-4106",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.