Revive Chiropractic, PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301009253 Issued in MI

Legal business name

REVIVE CHIROPRACTIC, PLLC

Practice address

6665 Western Ave
Glen Arbor, MI 49636-5103

Phone

(231) 334-3123

NPI assigned

May 7, 2008

Last updated

Sep 3, 2008By 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. Jessica Anna Carden, D.C.

Title

Owner

Phone

(231) 334-3123

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1210118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220400000000",
    "number": "1477729689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "890 E NARLOCK RD",
            "city": "MAPLE CITY",
            "state": "MI",
            "postal_code": "496648767",
            "telephone_number": "231-334-3123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6665 WESTERN AVE",
            "city": "GLEN ARBOR",
            "state": "MI",
            "postal_code": "496365103",
            "telephone_number": "231-334-3123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REVIVE CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-07",
        "last_updated": "2008-09-03",
        "status": "A",
        "authorized_official_last_name": "CARDEN",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_middle_name": "ANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-334-3123",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009253",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CMS",
            "identifier": "OP43110",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Marie Ford, LMSW
• Keith Alan Gaede, R.PH.
• Glen Arbor Township (Glen Lake Fire Department)
• Charles J Kinzel, PHARMACIST
• Jessica A Myers, D.C.
• The Prescription Shop of Glen Arbor, Inc

• Chiropractor in Glen Arbor, MI
• Providers in Glen Arbor, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.