Clear Choice Chiropractic of Edwardsburg, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301007476 Issued in MI

Legal business name

CLEAR CHOICE CHIROPRACTIC OF EDWARDSBURG, P.C.

Practice address

69821 M 62 Ste 12
Edwardsburg, MI 49112-8807

Phone

(269) 663-6600

Fax

(269) 663-6609

NPI assigned

Nov 20, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Toby Andrew Mitchell, D.C.

Title

President

Phone

(269) 663-6600

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450310400000",
    "number": "1235384041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69821 M 62 STE 12",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491128807",
            "telephone_number": "269-663-6600",
            "fax_number": "269-663-6609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69821 M 62 STE 12",
            "city": "EDWARDSBURG",
            "state": "MI",
            "postal_code": "491128807",
            "telephone_number": "269-663-6600",
            "fax_number": "269-663-6609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR CHOICE CHIROPRACTIC OF EDWARDSBURG, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-20",
        "last_updated": "2015-12-17",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "TOBY",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "269-663-6600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007476",
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": "MI",
            "license": "7501001411",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Ann Bazata, OTR
• Beacon Health Ventures Michigan, Inc.
• Beacon Medical Group, Inc.
• Byron Counseling LLC
• Mary Rebecca Casteel
• George Erving Drake, MD
• Luke Eichorn, FNP-BC
• Stacey Marie Gappa, LCSW, LMSW
• Heather Gibson
• Jason Hartman

• Chiropractor in Edwardsburg, MI
• Providers in Edwardsburg, MI by specialty
• Chiropractor in Michigan

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