Organization Active NPI

Greater Life Family Chiropractic LLC

  • Clinic/Center
  • Newaygo, MI
National Provider Identifier
1336977248
Registry record updated Oct 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
GREATER LIFE FAMILY CHIROPRACTIC LLC
Practice address
135 W State Rd
Newaygo, MI 49337-8172
Phone
(231) 335-1199
NPI assigned
Jul 23, 2024
Last updated
Oct 3, 2024By the provider in NPPES
Organization subpart
Yes
Parent organization
GREATER LIFE FAMILY CHIROPRACTIC LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 3, 2024

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

Authorized official

Name
Jacqueline Prins, DCNPI 1811440167
Title
Chiropractor
Phone
(408) 679-4238

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
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

135 W State Rd
Newaygo, MI 49337-8172

Mailing address

653 E 128TH St
Grant, MI 49327-9652
Phone (408) 679-4238

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241113002862 MI Part B Supplier - Clinic/Group Practice 5991239972 Receives reassigned benefits from 1 practitioner
Practice locations: Newaygo, MI

National Provider Directory

National Provider Directory
Part of
Greater Life Family Chiropractic LLC

Locations

135 W State Rd
Newaygo, MI 49337
Phone (231) 335-1199

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": "1721692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727913600000",
    "number": "1336977248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "653 E 128TH ST",
            "city": "GRANT",
            "state": "MI",
            "postal_code": "493279652",
            "telephone_number": "408-679-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 W STATE RD",
            "city": "NEWAYGO",
            "state": "MI",
            "postal_code": "493378172",
            "telephone_number": "231-335-1199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER LIFE FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "GREATER LIFE FAMILY CHIROPRACTIC LLC",
        "enumeration_date": "2024-07-23",
        "last_updated": "2024-10-03",
        "certification_date": "2024-10-03",
        "status": "A",
        "authorized_official_last_name": "PRINS",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "408-679-4238",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newaygo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2024; 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.