Organization Active NPI

Susan Isaacs DC LLC

  • Chiropractor
  • Spring Lake, MI
National Provider Identifier
1205411626
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SUSAN ISAACS DC LLC
Practice address
17208 Van Wagoner Rd Ste B
Spring Lake, MI 49456-9702
Phone
(616) 402-3418
NPI assigned
Mar 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Authorized official

Name
Susan Isaacs, DCNPI 1043450026
Title
Owner
Phone
(616) 402-3418

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 Primary

Addresses

Primary practice location

17208 Van Wagoner Rd Ste B
Spring Lake, MI 49456-9702

Mailing address

17208 Van Wagoner Rd Ste B
Spring Lake, MI 49456-9702
Phone (616) 402-3418

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210413000376 MI Part B Supplier - Clinic/Group Practice 7719395755 Receives reassigned benefits from 1 practitioner
Practice locations: Spring Lake, MI

National Provider Directory

National Provider Directory

Locations

17208 Van Wagoner Rd
Ste B
Spring Lake, MI 49456
Phone (616) 402-3418

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": "1615939200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1615939200000",
    "number": "1205411626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17208 VAN WAGONER RD STE B",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-402-3418"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17208 VAN WAGONER RD STE B",
            "city": "SPRING LAKE",
            "state": "MI",
            "postal_code": "494569702",
            "telephone_number": "616-402-3418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUSAN ISAACS DC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A",
        "authorized_official_last_name": "ISAACS",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-402-3418",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring Lake, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.