NPIMap

Organization Active NPI

Rivertown Family Chiropractic LLC

  • Chiropractor
  • Wyoming, MI
National Provider Identifier
1447671276
Registry record updated Apr 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009952 Issued in MI
Legal business name
RIVERTOWN FAMILY CHIROPRACTIC LLC
Practice address
4020 Del Mar Dr SW
Ste 100
Wyoming, MI 49418
Phone
(162) 143-1116
NPI assigned
Dec 20, 2013
Last updated
Apr 2, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2024

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

Authorized official

Name
Mark Wolfman, D.C.NPI 1043578065
Title
Owner
Phone
(248) 320-2844

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009952 MI Primary

Addresses

Primary practice location

4020 Del Mar Dr SW
Ste 100
Wyoming, MI 49418

Mailing address

4693 Wilson Ave SW Ste K
Grandville, MI 49418-8762

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140228001873 MI Part B Supplier - Clinic/Group Practice 2163652652 Receives reassigned benefits from 8 practitioners
Practice locations: Wyoming, MI

National Provider Directory

National Provider Directory

Locations

4020 Del Mar Dr SW
Ste 100
Wyoming, MI 49418
Phone (616) 214-3111

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1387497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1712016000000",
    "number": "1447671276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4693 WILSON AVE SW STE K",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494188762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4020 DEL MAR DR SW",
            "address_2": "STE 100",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "49418",
            "telephone_number": "162-143-1116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RIVERTOWN FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-20",
        "last_updated": "2024-04-02",
        "certification_date": "2024-03-29",
        "status": "A",
        "authorized_official_last_name": "WOLFMAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-320-2844",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.