Daniel Nelson Mikel

Individual provider Active NPI Chiropractor · Grass Lake, MI

NPI 1447413380 · NPPES record last updated Oct 20, 2008

Key facts

NPI
1447413380
Entity type
Individual (NPI type 1)
Primary specialty
Chiropractor 111N00000X
License
2301009352 (MI)
Practice address
125 W Michigan Ave
Grass Lake, MI 49240-9188
Phone
(517) 522-8315
NPI assigned
Jul 9, 2008
Sex
Male
Sole proprietor
Yes

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 and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

139 W Michigan Ave
Grass Lake, MI 49240-9188
Phone (517) 522-8315

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MI

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20080725000299 MI Practitioner - Chiropractic 3072686955 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Grass Lake Chiropractic Center, PLLC Chiropractor Current
since Jun 2, 2008
Accepting new patients

Locations

139 W Michigan Ave
Grass Lake, MI 49240
Phone (517) 522-8315

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009352 MI Yes

Addresses

Primary practice location

125 W Michigan Ave
Grass Lake, MI 49240-9188

Mailing address

PO Box 141
Grass Lake, MI 49240-0141

Other identifiers

IdentifierTypeStateIssuer
950C812990OtherMIBLUE CROSS BLUE SHIELD

Other providers in Grass Lake, MI

All providers in Grass Lake, MI · Chiropractor in Michigan

Sources for this page

Verify at the official NPI Registry.