Organization Active NPI

Conn Chiropractic Clinic, PLLC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1407382963
Registry record updated May 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010529 Issued in MI
Legal business name
CONN CHIROPRACTIC CLINIC, PLLC
Practice address
3097 29TH St SE
Grand Rapids, MI 49512-1726
Phone
(616) 855-0510
Fax
(855) 710-7034
NPI assigned
May 3, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2017

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

Authorized official

Name
Dr. Kyle Adam Conn, D.C.
Title
Chiropractor
Phone
(616) 855-0510

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301010529 MI Primary

Addresses

Primary practice location

3097 29TH St SE
Grand Rapids, MI 49512-1726

Mailing address

3097 29TH St SE
Grand Rapids, MI 49512-1726
Phone (616) 855-0510

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1493769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493769600000",
    "number": "1407382963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3097 29TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121726",
            "telephone_number": "616-855-0510",
            "fax_number": "855-710-7034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3097 29TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495121726",
            "telephone_number": "616-855-0510",
            "fax_number": "855-710-7034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONN CHIROPRACTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-03",
        "last_updated": "2017-05-03",
        "status": "A",
        "authorized_official_last_name": "CONN",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "ADAM",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "616-855-0510",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2017; 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.