Aamodt Chiropractic Clinic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

004756 Issued in MI

Legal business name

AAMODT CHIROPRACTIC CLINIC PC

Practice address

1805 44TH St SE
Grand Rapids, MI 49508-5005

Phone

(616) 455-4200

Fax

(616) 455-4201

NPI assigned

Nov 15, 2013

Last updated

Nov 15, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Garth Aamodt, D.C.NPI 1710975370

Title

Owner

Phone

(616) 455-4200

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

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.

• Wayne Garth Aamodt, D.C.

  • Chiropractor
  • Grand Rapids, MI
  • NPI 1710975370
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1384473600000",
    "number": "1457781171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1805 44TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495085005",
            "telephone_number": "616-455-4200",
            "fax_number": "616-455-4201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1805 44TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495085005",
            "telephone_number": "616-455-4200",
            "fax_number": "616-455-4201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AAMODT CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2013-11-15",
        "status": "A",
        "authorized_official_last_name": "AAMODT",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "GARTH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-455-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "004756",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2013; 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.