NPIMap

Organization Active NPI

Holly York LLC

Doing business as Spinal Care Center

  • Chiropractor
  • Kentwood, MI
National Provider Identifier
1073803250
Registry record updated Dec 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009429 Issued in MI
Legal business name
HOLLY YORK LLC
Doing business as
Spinal Care Center
Practice address
3138 Broadmoor Ave SE
Kentwood, MI 49512-1845
Phone
(616) 575-9105
Fax
(616) 575-9107
NPI assigned
Apr 8, 2011
Last updated
Dec 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2014

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

Authorized official

Name
Holly Elizebeth York, D.C.NPI 1376728568
Title
Owner/Chiropractor
Phone
(616) 530-7474

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009429 MI Primary

Addresses

Primary practice location

3138 Broadmoor Ave SE
Kentwood, MI 49512-1845

Mailing address

3138 Broadmoor Ave SE
Kentwood, MI 49512-1845
Phone (616) 575-9105

Other identifiers 2

IdentifierTypeStateIssuer
1922191048MedicaidMI
1376728568OtherMIMEDICAID INDIVIDUAL ID

Other names 1

  • Spinal Care Center Doing business as

National Provider Directory

National Provider Directory

Locations

2845 Wilson Ave SW
Ste A
Grandville, MI 49418
Phone (616) 530-7474

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419292800000",
    "number": "1073803250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3138 BROADMOOR AVE SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495121845",
            "telephone_number": "616-575-9105",
            "fax_number": "616-575-9107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3138 BROADMOOR AVE SE",
            "city": "KENTWOOD",
            "state": "MI",
            "postal_code": "495121845",
            "telephone_number": "616-575-9105",
            "fax_number": "616-575-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HOLLY YORK LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-08",
        "last_updated": "2014-12-23",
        "status": "A",
        "authorized_official_last_name": "YORK",
        "authorized_official_first_name": "HOLLY",
        "authorized_official_middle_name": "ELIZEBETH",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "616-530-7474",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009429",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1922191048",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID INDIVIDUAL ID",
            "identifier": "1376728568",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spinal Care Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kentwood, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 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.