Individual provider Active NPI

Carly F Sorrell, DC

  • Chiropractor
  • Caledonia, MI
National Provider Identifier
1376819219
Registry record updated Sep 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009599 Issued in MI
Practice address
6477 Cherry Meadow Dr SE Ste 3
Caledonia, MI 49316-7351
Phone
(616) 322-4984
NPI assigned
Mar 26, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 10, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X L1646945 MI
Chiropractor 111N00000X 2301009599 MI Primary

Addresses

Primary practice location

6477 Cherry Meadow Dr SE Ste 3
Caledonia, MI 49316-7351

Mailing address

6477 Cherry Meadow Dr SE Ste 3
Caledonia, MI 49316-7351
Phone (616) 322-4984

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210524000721 MI Practitioner - Chiropractic 5496154544 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009599MIMDChiropractor
L1646945MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic and Beyond Chiropractor CurrentSince Apr 20, 2021 Accepting new patients
C & R Family Chiropractic Center Chiropractor PastSince Sep 1, 2021 Accepting new patients

Locations

6477 Cherry Meadow Dr SE
Ste 3
Caledonia, MI 49316
Phone (616) 322-4984

6208 Kalamazoo Ave SE
Ste B
Grand Rapids, MI 49508
Phone (616) 322-4984

Organizations & group practices 2

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": "1332720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631232000000",
    "number": "1376819219",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6477 CHERRY MEADOW DR SE STE 3",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167351",
            "telephone_number": "616-322-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6477 CHERRY MEADOW DR SE STE 3",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493167351",
            "telephone_number": "616-322-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORRELL",
        "first_name": "CARLY",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-26",
        "last_updated": "2021-09-10",
        "certification_date": "2021-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "L1646945",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Caledonia, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2021; 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.