Individual provider Active NPI

Bethany Jean Kolarik, D.C

  • Chiropractor
  • Traverse City, MI
National Provider Identifier
1124174370
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301006972 Issued in MI
Practice address
1203 E 8TH St
Traverse City, MI 49686-2938
Phone
(231) 935-4849
NPI assigned
Jan 27, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2301006972MIMDChiropractor

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301006972 MI Primary

Addresses

NPPES NPI Registry

Primary practice location

1203 E 8TH St
Traverse City, MI 49686-2938

Mailing address

1203 E 8TH St
Traverse City, MI 49686-2938
Phone (231) 935-4849

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1169856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1124174370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862938",
            "telephone_number": "231-935-4849"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 E 8TH ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496862938",
            "telephone_number": "231-935-4849"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLARIK",
        "first_name": "BETHANY",
        "middle_name": "JEAN",
        "credential": "D.C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.