Berrien Family Chiropractic, Inc.
Organization Active NPI Chiropractor · Niles, MI
NPI 1508944679 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1508944679
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2301007398 (MI)
- Legal business name
- BERRIEN FAMILY CHIROPRACTIC, INC.
- Practice address
- 2028 S 11TH St
Niles, MI 49120-4074 - Phone
- (269) 683-1700
- Fax
- (269) 683-7038
- NPI assigned
- Nov 2, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Rosamond C Soanes, D.C.
- Title
- Director
- Phone
- (269) 683-1700
Practitioners 3
-
Rosamond C Soanes, D.C.
-
Melody A Edwards, LMT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050224000811 | MI | Part B Supplier - Clinic/Group Practice | 0042263584 |
Receives reassigned benefits from 1 practitioner Practice locations: Berrien Springs, MI; Niles, MI |
National Provider Directory
Locations
9046 US Highway 31
Ste 2
Berrien Springs, MI 49103
Phone (269) 471-3006
2028 S 11th St
Niles, MI 49120
Phone (269) 683-1700
1036 Bell Rd
Niles, MI 49120
Phone (269) 683-1700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 2301007398 | MI | Yes |
Addresses
Primary practice location
2028 S 11TH St
Niles, MI 49120-4074
Mailing address
2028 S 11TH St
Niles, MI 49120-4074
Phone (269) 683-1700
Other providers in Niles, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.