Organization Active NPI

Tri-City Soft Tissue & Spine PLLC

  • Chiropractor
  • Midland, MI
National Provider Identifier
1164963310
Registry record updated Mar 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010058 Issued in MI
Legal business name
TRI-CITY SOFT TISSUE & SPINE PLLC
Practice address
810 W Wackerly St
Midland, MI 48640-4716
Phone
(989) 751-3979
Fax
(989) 548-6033
NPI assigned
Mar 20, 2017
Last updated
Mar 20, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2017

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

Authorized official

Name
Dr. Ryan R Madigan, D.C.NPI 1356770119
Title
Owner
Phone
(989) 751-3979

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
Chiropractor 111N00000X 2301010058 MI Primary

Addresses

Primary practice location

810 W Wackerly St
Midland, MI 48640-4716

Mailing address

810 W Wackerly St
Midland, MI 48640-4716
Phone (989) 751-3979

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170426001520 MI Part B Supplier - Clinic/Group Practice 3274810437 Receives reassigned benefits from 1 practitioner
Practice locations: Midland, MI

National Provider Directory

National Provider Directory

Locations

5912 Eastman Ave
Midland, MI 48640
Phone (517) 832-6403

810 W Wackerly St
Midland, MI 48640
Phone (989) 495-2332

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1489968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1489968000000",
    "number": "1164963310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404716",
            "telephone_number": "989-751-3979",
            "fax_number": "989-548-6033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 W WACKERLY ST",
            "city": "MIDLAND",
            "state": "MI",
            "postal_code": "486404716",
            "telephone_number": "989-751-3979",
            "fax_number": "989-548-6033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-CITY SOFT TISSUE & SPINE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-20",
        "last_updated": "2017-03-20",
        "status": "A",
        "authorized_official_last_name": "MADIGAN",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "989-751-3979",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2017; 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.