Individual provider Active NPI

Ronald Rabineau III, D.C.

  • Chiropractor
  • Grandville, MI
National Provider Identifier
1396131413
Registry record updated Sep 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010279 Issued in MI
Practice address
6293 Kenowa Ave SW
Grandville, MI 49418-9405
Phone
(616) 730-1137
NPI assigned
Apr 15, 2015
Last updated
Sep 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010279 MI Primary

Addresses

Primary practice location

6293 Kenowa Ave SW
Grandville, MI 49418-9405

Mailing address

6293 Kenowa Ave SW
Grandville, MI 49418-9405
Phone (616) 730-1137

Other identifiers 1

IdentifierTypeStateIssuer
204691707MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150624001765 MI Practitioner - Chiropractic 8527379064 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6293 Kenowa Ave SW
Grandville, MI 49418-9405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
JFC Chiropractor CurrentSince Jul 23, 2021 Accepting new patients
Lakeshore Family Chiropractic, PLC CurrentSince Jun 2, 2015 Accepting new patients
Big Rapids Chiropractic, PLC Chiropractor PastSince Jun 2, 2015 Accepting new patients

Locations

6293 Kenowa Ave SW
Grandville, MI 49418
Phone (248) 941-2634

258 James St
Ste 10
Holland, MI 49424
Phone (616) 396-6635

Organizations & group practices 3

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": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632268800000",
    "number": "1396131413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6293 KENOWA AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494189405",
            "telephone_number": "616-730-1137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6293 KENOWA AVE SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494189405",
            "telephone_number": "616-730-1137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABINEAU",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-04-15",
        "last_updated": "2021-09-22",
        "certification_date": "2021-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010279",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "204691707",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2021; 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.