Travis Grace, DC
Individual provider Active NPI Chiropractor · Kimball, MI
NPI 1124505656 · NPPES record last updated Jun 15, 2022
Key facts
- NPI
- 1124505656
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2301010676 (MI)
- Practice address
- 2837 Stable Dr Ste B
Kimball, MI 48074-1441 - Phone
- (810) 432-8829
- NPI assigned
- Jul 27, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2837 Stable Dr
Suite B
Kimball, MI 48074-1441
Phone (810) 432-8829
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20181022001160 | MI | Practitioner - Chiropractic | 4789937707 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301010676 | MI | MD | Chiropractor |
| G620802585983 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impact Chiropractic PC | Chiropractor | Current |
Accepting new patients |
| Klapp Chiropractic Life Center, LLC | Chiropractor | Current |
Accepting new patients |
Locations
4748 Washtenaw Ave
Ann Arbor, MI 48108
Phone (734) 434-1100
2837 Stable Dr
Ste B
Kimball, MI 48074
Phone (810) 432-8829
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | G620802585983 | MI | |
| Chiropractor | 111N00000X | 2301010676 | MI | Yes |
Addresses
Primary practice location
2837 Stable Dr Ste B
Kimball, MI 48074-1441
Mailing address
2837 Stable Dr Ste B
Kimball, MI 48074-1441
Phone (810) 432-8829
Other providers in Kimball, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 15, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.