NPIMap

Organization Active NPI

Heib Chiropractic Clinic, P.C.

  • Sports Physician Chiropractor
  • Portage, MI
National Provider Identifier
1306119276
Registry record updated May 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
6816 Issued in MI
Legal business name
HEIB CHIROPRACTIC CLINIC, P.C.
Practice address
2225 E Centre Ave
Portage, MI 49002-4421
Phone
(269) 324-0100
NPI assigned
Feb 22, 2012
Last updated
May 22, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2012

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

Authorized official

Name
Dr. Andrew J Heib, CCSPNPI 1235112731
Title
Chiropractor
Phone
(269) 324-0100

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X 6816 MI Primary

Addresses

Primary practice location

2225 E Centre Ave
Portage, MI 49002-4421

Mailing address

2225 E Centre Ave
Portage, MI 49002-4421
Phone (269) 324-0100

Other identifiers 2

IdentifierTypeStateIssuer
269464414MedicaidMI
MI5489OtherMIMEDICARE PTAN

National Provider Directory

National Provider Directory

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": "1329868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1306119276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2225 E CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024421",
            "telephone_number": "269-324-0100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2225 E CENTRE AVE",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490024421",
            "telephone_number": "269-324-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEIB CHIROPRACTIC CLINIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "HEIB",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "269-324-0100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "CCSP"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "MI",
            "license": "6816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269464414",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "MI5489",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.