NPIMap

Organization Active NPI

Golan Integrated Physical Medicine

Doing business as Advanced Spine and Posture

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1316419260
Registry record updated Apr 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
GOLAN INTEGRATED PHYSICAL MEDICINE
Doing business as
Advanced Spine and Posture
Practice address
3097 29TH St SE
Grand Rapids, MI 49512-1726
Phone
(616) 741-2232
Fax
(877) 866-2053
NPI assigned
Dec 17, 2018
Organization subpart
Yes
Parent organization
GOLAN INTEGRATED PHYSICAL MEDICINEAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 25, 2022

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

Authorized official

Name
David R Golan, MDNPI 1457441206
Title
Medical Director
Phone
(702) 419-5379

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

3097 29TH St SE
Grand Rapids, MI 49512-1726

Mailing address

PO Box 561564
Denver, CO 80256-1564
Phone (702) 202-1850

Other names 1

  • Advanced Spine and Posture Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20190904001198 MI Part B Supplier - Clinic/Group Practice 2365678125 Receives reassigned benefits from 10 practitioners
Practice locations: Lansing, MI; Grand Rapids, MI
O20220503002011 MI DME Supplier - Physician - ChiropracticDME Supplier - Physician - Physical and Rehabilitation 2365678125 Practice locations: Grand Rapids, MI

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Part of
Golan Integrated Physical

Locations

3097 29th St SE
Ste B
Grand Rapids, MI 49512
Phone (616) 741-2232

2770 S Maryland Pkwy
Ste 200
Las Vegas, NV 89109
Phone (702) 478-9594

500 S Rancho Dr
Ste 9
Las Vegas, NV 89106
Phone (702) 870-8060

Practitioners & affiliated clinicians

Practitioners 33

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.

View all 33

NPI Registry JSON

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1650844800000",
    "number": "1316419260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 561564",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802561564",
            "telephone_number": "702-202-1850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3097 29TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121726",
            "telephone_number": "616-741-2232",
            "fax_number": "877-866-2053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLAN INTEGRATED PHYSICAL MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GOLAN INTEGRATED PHYSICAL MEDICINE",
        "enumeration_date": "2018-12-17",
        "last_updated": "2022-04-25",
        "certification_date": "2022-04-25",
        "status": "A",
        "authorized_official_last_name": "GOLAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "702-419-5379",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Spine and Posture",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Spine and Posture",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2022; 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.