James Ryan Dietrick, D.C.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

2301010554 Issued in MI

Practice address

14321 Northland Dr
Ste 1
Big Rapids, MI 49307-2310

Phone

(231) 629-8833

Fax

(231) 629-8834

NPI assigned

Mar 10, 2016

Last updated

Jul 9, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Northwest Chiropractic and Sports Medicine PLLC

  dba Northwest Chiropractic and Sports Medicine

  • Sports Physician Chiropractor
  • Big Rapids, MI
  • NPI 1285150888
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1457568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1346601879",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14321 NORTHLAND DR",
            "address_2": "STE 1",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072310",
            "telephone_number": "616-916-6753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14321 NORTHLAND DR",
            "address_2": "STE 1",
            "city": "BIG RAPIDS",
            "state": "MI",
            "postal_code": "493072310",
            "telephone_number": "231-629-8833",
            "fax_number": "231-629-8834"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2849 S Baldwin Ave",
            "address_purpose": "LOCATION",
            "city": "Fremont",
            "state": "MI",
            "postal_code": "494127816",
            "country_code": "US",
            "telephone_number": "616-916-6753",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "621 N State St",
            "address_purpose": "LOCATION",
            "city": "Big Rapids",
            "state": "MI",
            "postal_code": "493071452",
            "country_code": "US",
            "telephone_number": "231-629-8833",
            "fax_number": "231-796-3510",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DIETRICK",
        "first_name": "JAMES",
        "middle_name": "RYAN",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-10",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010554",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "5702",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "MI",
            "license": "2301010554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savanna Kristine Deloach
• Melissa Ann Deniel, M.D.
• Jamie Lee Derevage, LMSW, SSW
• Gail A Desnoyers, MD
• Sarah Marie Devries, OD
• Amy Elaine Dinardo, O.D.
• Stacy M Dodd, R.N
• Toni Marie Dodge, RNC-OB, C-EFM, NP-BC
• Kendra Lee Dolorfino, CPNP
• Jenna Lynn Dotson

• Sports Physician Chiropractor in Big Rapids, MI
• Providers in Big Rapids, MI by specialty
• Sports Physician Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; 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.