Organization Active NPI

Bryan a. Baetens, D.C., P.C.

Doing business as Baetens Chiropractic Center

  • Chiropractor
  • Saint Clair Shores, MI
National Provider Identifier
1477607679
Registry record updated Jun 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BRYAN A. BAETENS, D.C., P.C.
Doing business as
Baetens Chiropractic Center
Practice address
26000 Harper Avenue
Suite a
Saint Clair Shores, MI 48081
Phone
(586) 774-7920
Fax
(586) 774-8336
NPI assigned
Jan 23, 2007
Last updated
Jun 13, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2016

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

Authorized official

Name
Bryan A Baetens, D.C., P.C., D.C.
Title
President
Phone
(586) 774-7920

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301004667 MI
Chiropractor 111N00000X Primary

Addresses

Primary practice location

26000 Harper Avenue
Suite a
Saint Clair Shores, MI 48081

Mailing address

26000 Harper Avenue
Suite a
Saint Clair Shores, MI 48081
Phone (586) 774-7920

Other names 1

  • Baetens Chiropractic Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051018000486 MI Part B Supplier - Clinic/Group Practice 6608892856 Receives reassigned benefits from 2 practitioners
Practice locations: Saint Clair Shores, MI

National Provider Directory

National Provider Directory

Locations

19416 E 10 Mile Rd
Eastpointe, MI 48021
Phone (586) 774-7920

26000 Harper Ave
Ste A
St Clr Shores, MI 48081
Phone (586) 774-7920

Practitioners & affiliated clinicians

Practitioners 7

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": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465776000000",
    "number": "1477607679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26000 HARPER AVENUE",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-774-7920",
            "fax_number": "586-774-8336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26000 HARPER AVENUE",
            "address_2": "SUITE A",
            "city": "SAINT CLAIR SHORES",
            "state": "MI",
            "postal_code": "48081",
            "telephone_number": "586-774-7920",
            "fax_number": "586-774-8336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN A. BAETENS, D.C., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2016-06-13",
        "status": "A",
        "authorized_official_last_name": "BAETENS, D.C., P.C.",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "586-774-7920",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301004667",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baetens Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saint Clair Shores, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2016; 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.