Organization Active NPI

Clare Hometown Chiropractic PC

  • Chiropractor
  • Clare, MI
National Provider Identifier
1245505064
Registry record updated Jun 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009243 Issued in MI
Legal business name
CLARE HOMETOWN CHIROPRACTIC PC
Practice address
218 E 5TH St
Clare, MI 48617-1556
Phone
(989) 424-6360
Fax
(989) 424-6362
NPI assigned
Mar 12, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2012

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

Authorized official

Name
Dr. Kurt James Keppner, D.C.NPI 1457464307
Title
President
Phone
(989) 424-6360

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 2301009243 MI Primary

Addresses

Primary practice location

218 E 5TH St
Clare, MI 48617-1556

Mailing address

218 E 5TH St
Clare, MI 48617-1556
Phone (989) 424-6360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120525000587 MI Part B Supplier - Clinic/Group Practice 8921261116 Receives reassigned benefits from 1 practitioner
Practice locations: Clare, MI

National Provider Directory

National Provider Directory

Locations

218 E 5th St
Clare, MI 48617
Phone (517) 386-9027

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": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339632000000",
    "number": "1245505064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "218 E 5TH ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171556",
            "telephone_number": "989-424-6360",
            "fax_number": "989-424-6362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "218 E 5TH ST",
            "city": "CLARE",
            "state": "MI",
            "postal_code": "486171556",
            "telephone_number": "989-424-6360",
            "fax_number": "989-424-6362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARE HOMETOWN CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-06-14",
        "status": "A",
        "authorized_official_last_name": "KEPPNER",
        "authorized_official_first_name": "KURT",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "989-424-6360",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clare, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2012; 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.