Organization Active NPI

Northern Lights Chiropractic, PLLC

  • Chiropractor
  • Traverse City, MI
National Provider Identifier
1164894648
Registry record updated Oct 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010350 Issued in MI
Legal business name
NORTHERN LIGHTS CHIROPRACTIC, PLLC
Practice address
2506 Crossing Cir
Suite a
Traverse City, MI 49684-7955
Phone
(231) 421-3333
Fax
(231) 421-3355
NPI assigned
Oct 23, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2015

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

Authorized official

Name
Ramona Pleva, D.C.NPI 1154798981
Title
Chiropractor
Phone
(231) 510-8682

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 2301010350 MI Primary

Addresses

Primary practice location

2506 Crossing Cir
Suite a
Traverse City, MI 49684-7955

Mailing address

2506 Crossing Cir
Suite a
Traverse City, MI 49684-7955
Phone (231) 421-3333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151028000802 MI Part B Supplier - Clinic/Group Practice 6608185996 Receives reassigned benefits from 1 practitioner
Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory

Locations

510 Depot View Dr
Ste 13
Traverse City, MI 49686
Phone (231) 668-5050

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": "1445558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1445990400000",
    "number": "1164894648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2506 CROSSING CIR",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847955",
            "telephone_number": "231-421-3333",
            "fax_number": "231-421-3355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2506 CROSSING CIR",
            "address_2": "SUITE A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847955",
            "telephone_number": "231-421-3333",
            "fax_number": "231-421-3355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN LIGHTS CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-23",
        "last_updated": "2015-10-28",
        "status": "A",
        "authorized_official_last_name": "PLEVA",
        "authorized_official_first_name": "RAMONA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "231-510-8682",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010350",
            "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 Oct 28, 2015; 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.