Organization Active NPI

Elite Movement Chiropractic Clinic PLC

  • Sports Physician Chiropractor
  • Petoskey, MI
National Provider Identifier
1447724620
Registry record updated Mar 19, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Legal business name
ELITE MOVEMENT CHIROPRACTIC CLINIC PLC
Practice address
2810 Charlevoix Rd Ste 101
Petoskey, MI 49770-8421
Phone
(231) 881-9280
Fax
(231) 881-9288
NPI assigned
Jan 22, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2019

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

Authorized official

Name
Dr. Garrett John-Otto Kuhlman, DC, CCSPNPI 1871904474
Title
Chiropractic Physician
Phone
(517) 442-8757

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
Sports Physician ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NS0005X Primary

Addresses

Primary practice location

2810 Charlevoix Rd Ste 101
Petoskey, MI 49770-8421

Mailing address

2810 Charlevoix Rd Ste 101
Petoskey, MI 49770-8421
Phone (231) 881-9280

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190326001194 MI Part B Supplier - Clinic/Group Practice 0345580510 Receives reassigned benefits from 1 practitioner
Practice locations: Petoskey, MI

National Provider Directory

National Provider Directory

Locations

2810 Charlevoix Rd
Ste 101
Petoskey, MI 49770
Phone (231) 881-9280

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1548115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552953600000",
    "number": "1447724620",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2810 CHARLEVOIX RD STE 101",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708421",
            "telephone_number": "231-881-9280",
            "fax_number": "231-881-9288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2810 CHARLEVOIX RD STE 101",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497708421",
            "telephone_number": "231-881-9280",
            "fax_number": "231-881-9288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE MOVEMENT CHIROPRACTIC CLINIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-22",
        "last_updated": "2019-03-19",
        "status": "A",
        "authorized_official_last_name": "KUHLMAN",
        "authorized_official_first_name": "GARRETT",
        "authorized_official_middle_name": "JOHN-OTTO",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "517-442-8757",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, CCSP"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Petoskey, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2019; 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.