Individual provider Active NPI

Kyle Conn, D.C.

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1346773181
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010529 Issued in MI
Practice address
3097 29TH St SE
Grand Rapids, MI 49512-1726
Phone
(616) 855-0510
Fax
(855) 710-7034
NPI assigned
Apr 8, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010529 MI Primary

Addresses

Primary practice location

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

Mailing address

3097 29TH St SE
Grand Rapids, MI 49512-1726
Phone (810) 656-0539

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170517001057 MI Practitioner - Chiropractic 4688942816 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saini Family Wellness, PLLCGroup PAC ID 7416342696, 2 clinicians

Practice addresses (Care Compare)

1440 Torrey Rd
Suite D
Fenton, MI 48430-1340
Phone (810) 373-5536

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301010529MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Saini Family Wellness, PLLC CurrentSince Aug 30, 2023 Accepting new patients

Locations

1440 Torrey Rd
Ste D
Fenton, MI 48430
Phone (810) 373-5536

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493596800000",
    "number": "1346773181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3097 29TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121726",
            "telephone_number": "810-656-0539",
            "fax_number": "855-710-7034"
        },
        {
            "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": "616-855-0510",
            "fax_number": "855-710-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONN",
        "first_name": "KYLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-08",
        "last_updated": "2017-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 May 1, 2017; 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.