Blake Rushford Spooner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301009161 Issued in MI

Practice address

244 James St
Suite B
Holland, MI 49424-2980

Phone

(616) 403-5135

NPI assigned

Jul 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2006

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeshore Family Chiropractic PLCGroup PAC ID 1759386790, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lakeshore Family Chiropractic, PLC

  • Clinic/Center
  • Holland, MI
  • NPI 1508978933
  Medicare reassignment Care Compare group NPD Authorized official
• Big Rapids Chiropractic, PLC

  • Chiropractor
  • Big Rapids, MI
  • NPI 1760954697
  NPD

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584057600000",
    "number": "1245263128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 JAMES ST",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494241806",
            "telephone_number": "616-396-6635",
            "fax_number": "616-499-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "244 JAMES ST",
            "address_2": "SUITE B",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494242980",
            "telephone_number": "616-403-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPOONER",
        "first_name": "BLAKE",
        "middle_name": "RUSHFORD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2020-03-13",
        "certification_date": "2020-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendi Kay Speese
• Jenna Lynn Spek, LMSW
• Tyler James Spiering, MD
• Spine Align Products LLC
• David Lee Spoelma
• Samantha Jo Spooner, D.C.
• Holly Jean Sprick, RN
• Ashley Nichole St Andrew, PHARM.D
• Stacy McNeely LMSW PLC
• Roshel Catia Stafford, LMSW

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.