Obsidian Chiropractic, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

OBSIDIAN CHIROPRACTIC, LLC

Practice address

2504 Ardmore St SE Ste 102
Grand Rapids, MI 49506-4901

Phone

(850) 218-0677

NPI assigned

Nov 20, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Charles Justin Austin, DCNPI 1760959084

Title

Owner

Phone

(850) 218-0677

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Charles Justin Austin, DC

  • Chiropractor
  • Grand Rapids, MI
  • NPI 1760959084
  NPD Authorized official

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

{
    "created_epoch": "1574208000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1574208000000",
    "number": "1154967651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "319 LYON ST NE APT 1",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495033381",
            "telephone_number": "850-218-0677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2504 ARDMORE ST SE STE 102",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064901",
            "telephone_number": "850-218-0677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OBSIDIAN CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-20",
        "last_updated": "2019-11-20",
        "status": "A",
        "authorized_official_last_name": "AUSTIN",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-218-0677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cassandra Oberndorf, DO
• Sylvia Cristina Obert, MA
• Alexandra Jo Obetts, OTR/L
• Obf Enterprises LLC
• Anna Tuneka Obi, MSW, LLMSW
• Marie Yasmine Occes Francois
• Occupational Health Centers of Michigan, P.C.
• Occupational Health Centers of Michigan, P.C.
• Juan Ochoa
• Robert Conrad Ocomen

• Clinic/Center in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.