Individual provider Active NPI

Krista Kathleen Carpenter, D.C.

  • Chiropractor
  • Comstock Park, MI
National Provider Identifier
1114933454
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007299 Issued in MI
Practice address
6410 Alpine Ave NW
Suite C
Comstock Park, MI 49321-8001
Phone
(616) 785-7970
Fax
(616) 785-7973
NPI assigned
Jul 31, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007299 MI Primary

Addresses

Primary practice location

6410 Alpine Ave NW
Suite C
Comstock Park, MI 49321-8001

Mailing address

6410 Alpine Ave NW
Suite C
Comstock Park, MI 49321-8001
Phone (616) 785-7970

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110401000719 MI Practitioner - Chiropractic 7214111020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6410 Alpine Ave NW
Suite C
Comstock Park, MI 49321-9799
Phone (616) 785-7970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Wellness Center PC Chiropractor CurrentSince Apr 1, 2011 Accepting new patients

Locations

6410 Alpine Ave NW
Ste C
Comstock Park, MI 49321
Phone (616) 785-7970

Organizations & group practices 1

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": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114933454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6410 ALPINE AVE NW",
            "address_2": "SUITE C",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493218001",
            "telephone_number": "616-785-7970",
            "fax_number": "616-785-7973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6410 ALPINE AVE NW",
            "address_2": "SUITE C",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493218001",
            "telephone_number": "616-785-7970",
            "fax_number": "616-785-7973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "KRISTA",
        "middle_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007299",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Comstock Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.