Organization Active NPI

Fantastic Health Chiropractic, PLLC

  • Radiology Chiropractor
  • Muskegon, MI
National Provider Identifier
1114100690
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
Legal business name
FANTASTIC HEALTH CHIROPRACTIC, PLLC
Practice address
947 W Broadway Ave
Muskegon, MI 49441-3586
Phone
(231) 755-5400
Fax
(231) 755-5418
NPI assigned
Dec 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Tzuchiang Fan, D.C.
Title
Chiropractor
Phone
(231) 755-5400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0200X MI Primary

Addresses

Primary practice location

947 W Broadway Ave
Muskegon, MI 49441-3586

Mailing address

947 W Broadway Ave
Muskegon, MI 49441-3586
Phone (231) 755-5400

Other identifiers 1

IdentifierTypeStateIssuer
950F11202OtherMIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

947 W Broadway Ave
Muskegon, MI 49441
Phone (231) 755-5400

947 W Broadway Ave
Ste B
Muskegon, MI 49441
Phone (231) 755-5400

NPI Registry JSON

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

{
    "created_epoch": "1196985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1114100690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "947 W BROADWAY AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413586",
            "telephone_number": "231-755-5400",
            "fax_number": "231-755-5418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "947 W BROADWAY AVE",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413586",
            "telephone_number": "231-755-5400",
            "fax_number": "231-755-5418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FANTASTIC HEALTH CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-07",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "FAN",
        "authorized_official_first_name": "TZUCHIANG",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "231-755-5400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Radiology",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950F11202",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.