Organization Active NPI

Renew Health Family Chiropractic LLC

  • Chiropractor
  • Clare, MI
National Provider Identifier
1124489000
Registry record updated Mar 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010401 Issued in MI
Legal business name
RENEW HEALTH FAMILY CHIROPRACTIC LLC
Practice address
202 W State St
Clare, MI 48617-1241
Phone
(989) 424-6204
NPI assigned
Mar 18, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2021

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

Authorized official

Name
Dr. Kristin Heintz, DCNPI 1861853749
Title
Owner
Phone
(989) 424-6204

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 2301010401 MI Primary

Addresses

Primary practice location

202 W State St
Clare, MI 48617-1241

Mailing address

202 W State St
Clare, MI 48617-1241
Phone (989) 424-6204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160404000179 MI Part B Supplier - Clinic/Group Practice 7012214281 Receives reassigned benefits from 1 practitioner
Practice locations: Clare, MI

National Provider Directory

National Provider Directory

Locations

104 E 4th St
Clare, MI 48617
Phone (989) 386-2037

Practitioners & affiliated clinicians

Practitioners 1

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": "1458259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1616457600000",
    "number": "1124489000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 W STATE ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171241",
            "telephone_number": "989-424-6204"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 W STATE ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171241",
            "telephone_number": "989-424-6204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW HEALTH FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-18",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A",
        "authorized_official_last_name": "HEINTZ",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-424-6204",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clare, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.