Organization Active NPI

Back on Track Chiropractic P C

  • Chiropractor
  • Traverse City, MI
National Provider Identifier
1376845461
Registry record updated Nov 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008338 Issued in MI
Legal business name
BACK ON TRACK CHIROPRACTIC P C
Practice address
3335 S Airport Rd W
Suite 6a
Traverse City, MI 49684-7928
Phone
(231) 922-0421
Fax
(231) 922-9904
NPI assigned
Nov 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2010

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

Authorized official

Name
Dr. Bradley Schiller, D.C.NPI 1437119476
Title
Owner
Phone
(231) 922-0421

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301008338 MI Primary

Addresses

Primary practice location

3335 S Airport Rd W
Suite 6a
Traverse City, MI 49684-7928

Mailing address

3335 S Airport Rd W
Suite 6a
Traverse City, MI 49684-7928
Phone (231) 922-0421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101129000186 MI Part B Supplier - Clinic/Group Practice 3971799214 Receives reassigned benefits from 1 practitioner
Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory

Locations

3335 S Airport Rd W
Traverse City, MI 49684
Phone (231) 715-8466

3335 S Airport Rd W
Ste 6A
Traverse City, MI 49684
Phone (231) 922-0421

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290556800000",
    "number": "1376845461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3335 S AIRPORT RD W",
            "address_2": "SUITE 6A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847928",
            "telephone_number": "231-922-0421",
            "fax_number": "231-922-9904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 S AIRPORT RD W",
            "address_2": "SUITE 6A",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847928",
            "telephone_number": "231-922-0421",
            "fax_number": "231-922-9904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK ON TRACK CHIROPRACTIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-24",
        "status": "A",
        "authorized_official_last_name": "SCHILLER",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-922-0421",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2010; 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.