Individual provider Active NPI

Eric Winston Lipke Jr., DC

  • Chiropractor
  • Saint Clair, MI
National Provider Identifier
1073810149
Registry record updated Jul 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009726 Issued in MI
Practice address
201 N Riverside Ave Ste D-2a
Saint Clair, MI 48079-5491
Phone
(810) 289-3082
Fax
(810) 289-3213
NPI assigned
Feb 24, 2011
Last updated
Jul 11, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009726 MI Primary

Addresses

Primary practice location

201 N Riverside Ave Ste D-2a
Saint Clair, MI 48079-5491

Mailing address

201 N Riverside Ave Ste D-2a
Saint Clair, MI 48079-5491
Phone (810) 289-3082

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110317000886 MI Practitioner - Chiropractic 4082897723 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

201 N Riverside Ave
Suite A2
Saint Clair, MI 48079-5470
Phone (810) 210-8563

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009726MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Lipke Chiropractic & Wellness PC Chiropractor CurrentSince May 20, 2024 Accepting new patients
Swain Family Chiropractic P.C. Past Accepting new patients

Locations

201 N Riverside Ave
Ste A2
Saint Clair, MI 48079
Phone (810) 210-8563

201 N Riverside Ave
Ste D2A
Saint Clair, MI 48079
Phone (810) 289-3082

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1298505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720656000000",
    "number": "1073810149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N RIVERSIDE AVE STE D-2A",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795491",
            "telephone_number": "810-289-3082",
            "fax_number": "810-289-3213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N RIVERSIDE AVE STE D-2A",
            "city": "SAINT CLAIR",
            "state": "MI",
            "postal_code": "480795491",
            "telephone_number": "810-289-3082",
            "fax_number": "810-289-3213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPKE",
        "first_name": "ERIC",
        "middle_name": "WINSTON",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-02-24",
        "last_updated": "2024-07-11",
        "certification_date": "2024-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009726",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2024; 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.