Individual provider Active NPI

Bryan Alan Baetens, D.C.

  • Chiropractor
  • Saint Clair Shores, MI
National Provider Identifier
1386675957
Registry record updated Jun 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301004667 Issued in MI
Practice address
26000 Harper Avenue Suite a
Saint Clair Shores, MI 48081
Phone
(586) 774-7920
Fax
(586) 774-8336
NPI assigned
Jul 5, 2006
Last updated
Jun 22, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004667 MI Primary

Addresses

Primary practice location

26000 Harper Avenue Suite a
Saint Clair Shores, MI 48081

Mailing address

26000 Harper Avenue Suite a
Saint Clair Shores, MI 48081
Phone (586) 774-7920

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120705000401 MI Practitioner - Chiropractic 4587680731 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryan a Baetens DC PCGroup PAC ID 6608892856, 2 clinicians

Practice addresses (Care Compare)

26000 Harper Ave
Suite a
Saint Clair Shores, MI 48081-3773
Phone (586) 774-7920

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301004667MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bryan a. Baetens, D.C., P.C. Chiropractor CurrentSince Apr 1, 1988 Accepting new patients

Locations

19416 E 10 Mile Rd
Eastpointe, MI 48021
Phone (586) 774-7920

26000 Harper Ave
Ste A
St Clr Shores, MI 48081
Phone (586) 774-7920

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

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466553600000",
    "number": "1386675957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26000 HARPER AVENUE SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-774-7920",
            "fax_number": "586-774-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26000 HARPER AVENUE SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-774-7920",
            "fax_number": "586-774-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAETENS",
        "first_name": "BRYAN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2016-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2016; 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.