Chiropractic Care Grand Traverse, PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301005511 Issued in MI

Legal business name

CHIROPRACTIC CARE GRAND TRAVERSE, PC

Practice address

620 Second St
Traverse City, MI 49684-2272

Phone

(231) 922-0233

Fax

(231) 941-9832

NPI assigned

Jul 8, 2008

Organization subpart

No

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

Authorized official

Name

Mark J Zimmer, DC

Title

Owner

Phone

(231) 922-0233

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Jeral Keilsha Dennis, D.C.

  • Chiropractor
  • Traverse City, MI
  • NPI 1730362393
  NPD (past)

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

{
    "created_epoch": "1215475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215475200000",
    "number": "1407019698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SECOND ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842272",
            "telephone_number": "231-922-0233",
            "fax_number": "231-941-9832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SECOND ST",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842272",
            "telephone_number": "231-922-0233",
            "fax_number": "231-941-9832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC CARE GRAND TRAVERSE, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-08",
        "last_updated": "2008-07-08",
        "status": "A",
        "authorized_official_last_name": "ZIMMER",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-922-0233",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005511",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "MZ005511",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144355184",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Child & Family Services of Northwestern Michigan, Inc.
• Lisa Chimner, MD
• Carlistie Jean Chingwa
• Kristen Chippi, O.D.
• Chiropracther, PLLC
• Heather Marie Chisholm, DPT
• Michael Phillip Chisholm, DPT
• Choice Autism Center
• Choices Inc
• Judith S Christensen, PHARM.D.

• Chiropractor in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.