Organization Active NPI

Parkhurst Chiropractic Life Center PLC

  • Chiropractor
  • Holland, MI
National Provider Identifier
1104855006
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PARKHURST CHIROPRACTIC LIFE CENTER PLC
Practice address
364 Garden Ave
Holland, MI 49424-8656
Phone
(616) 392-9500
Fax
(616) 392-9662
NPI assigned
Jul 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Dr. Karla Anne Parkhurst, D.C.NPI 1457347916
Title
Chiropractor
Phone
(616) 392-9500

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 Primary

Addresses

Primary practice location

364 Garden Ave
Holland, MI 49424-8656

Mailing address

364 Garden Ave
Holland, MI 49424-8656
Phone (616) 392-9500

Other identifiers 2

IdentifierTypeStateIssuer
950G010320OtherMIBLUE CROSS BLUE SHIELD
DA8102OtherMIRAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040115000077 MI Part B Supplier - Clinic/Group Practice 7416858337 Receives reassigned benefits from 6 practitioners
Practice locations: Holland, MI

National Provider Directory

National Provider Directory

Locations

364 Garden Ave
Holland, MI 49424
Phone (616) 392-9500

11975 E Lakewood Blvd
Ste 3
Holland, MI 49424
Phone (616) 392-9500

Practitioners & affiliated clinicians

Practitioners 9

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": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1104855006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "364 GARDEN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248656",
            "telephone_number": "616-392-9500",
            "fax_number": "616-392-9662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "364 GARDEN AVE",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248656",
            "telephone_number": "616-392-9500",
            "fax_number": "616-392-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PARKHURST CHIROPRACTIC LIFE CENTER PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "PARKHURST",
        "authorized_official_first_name": "KARLA",
        "authorized_official_middle_name": "ANNE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "616-392-9500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950G010320",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DA8102",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.