NPIMap

Organization Active NPI

Great Lakes Chiropractic Orthopedics, PC

  • Orthopedic Chiropractor
  • Coldwater, MI
National Provider Identifier
1376868083
Registry record updated Oct 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic ChiropractorTaxonomy code 111NX0800X
License
SG007175 Issued in MI
Legal business name
GREAT LAKES CHIROPRACTIC ORTHOPEDICS, PC
Practice address
601 E Chicago Rd
Coldwater, MI 49036-8130
Phone
(517) 278-7246
Fax
(517) 279-2858
NPI assigned
Apr 6, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2010

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

Authorized official

Name
Dr. Sean P Groves, DCNPI 1144284167
Title
Owner
Phone
(517) 278-7246

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
Orthopedic ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NX0800X SG007175 MI Primary

Addresses

Primary practice location

601 E Chicago Rd
Coldwater, MI 49036-8130

Mailing address

601 E Chicago Rd
Coldwater, MI 49036-8130
Phone (517) 278-7246

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101008001243 MI Part B Supplier - Clinic/Group Practice 2062604994 Receives reassigned benefits from 7 practitioners
Practice locations: Sturgis, MI; Coldwater, MI

National Provider Directory

National Provider Directory

Locations

601 E Chicago Rd
Coldwater, MI 49036
Phone (517) 278-7246

100 S Lakeview Ave
Sturgis, MI 49091
Phone (269) 651-2320

204 E West St
Sturgis, MI 49091
Phone (269) 651-9448

Practitioners & affiliated clinicians

Practitioners 8

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": "1270512000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287446400000",
    "number": "1376868083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 E CHICAGO RD",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490368130",
            "telephone_number": "517-278-7246",
            "fax_number": "517-279-2858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 E CHICAGO RD",
            "city": "COLDWATER",
            "state": "MI",
            "postal_code": "490368130",
            "telephone_number": "517-278-7246",
            "fax_number": "517-279-2858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES CHIROPRACTIC ORTHOPEDICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-06",
        "last_updated": "2010-10-19",
        "status": "A",
        "authorized_official_last_name": "GROVES",
        "authorized_official_first_name": "SEAN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-278-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NX0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Orthopedic",
            "state": "MI",
            "license": "SG007175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coldwater, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.