Lake Michigan Chiropractic, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

KK2301009038 Issued in MI

Legal business name

LAKE MICHIGAN CHIROPRACTIC, PLLC

Practice address

4082 Red Arrow Hwy.
Saint Joseph, MI 49085-9431

Phone

(269) 408-8736

Fax

(269) 408-8790

NPI assigned

Oct 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kraig Alan Kirkdorfer, D.C.NPI 1922017672

Title

Doctor of Chiropractic

Phone

(269) 408-8736

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kraig Alan Kirkdorfer, D.C.

  • Chiropractor
  • Saint Joseph, MI
  • NPI 1922017672
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1144504010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4082 RED ARROW HWY.",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859431",
            "telephone_number": "269-408-8736",
            "fax_number": "269-408-8790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4082 RED ARROW HWY.",
            "city": "SAINT JOSEPH",
            "state": "MI",
            "postal_code": "490859431",
            "telephone_number": "269-408-8736",
            "fax_number": "269-408-8790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE MICHIGAN CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "KIRKDORFER",
        "authorized_official_first_name": "KRAIG",
        "authorized_official_middle_name": "ALAN",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "269-408-8736",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "KK2301009038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ingrid Kwak, FNP
• Katherine Westin Kwon, M.D.
• Kyle L. Vonk DDS P.C.
• Samantha Labay, D.O.
• Lake House Counseling PLLC
• Lake Michigan Hand Center, PC
• Lake Michigan Nephrology, L.L.C
• Lake Michigan Neurolgical Surgery
• Lake Michigan Oral & Maxillofacial Surgery PLLC
• Lake Michigan Sinus & Sleep Apnea Center, PLLC

• Chiropractor in Saint Joseph, MI
• Providers in Saint Joseph, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.