Charles Bryan Strother, DC FICPA

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CS007584 Issued in MI

Practice address

1 W Madison Ave
New Buffalo, MI 49117-1734

Phone

(269) 469-1310

Fax

(269) 469-3969

NPI assigned

Apr 4, 2006

Last updated

Jul 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1997

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Wellness Center, PC

  • Chiropractor
  • New Buffalo, MI
  • NPI 1992857932
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1144108800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1447212600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 W MADISON AVE",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491171734",
            "telephone_number": "269-469-1310",
            "fax_number": "269-469-3969"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 W MADISON AVE",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491171734",
            "telephone_number": "269-469-1310",
            "fax_number": "269-469-3969"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STROTHER",
        "first_name": "CHARLES",
        "middle_name": "BRYAN",
        "name_prefix": "Dr.",
        "credential": "DC  FICPA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-04",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "CS007584",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08002381A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in New Buffalo, MI
• Providers in New Buffalo, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.