Individual provider Active NPI

Colleen M Kill, DC

  • Chiropractor
  • Jackson, MI
National Provider Identifier
1578024485
Registry record updated Mar 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010790 Issued in MI
Practice address
610 W Michigan Ave
Jackson, MI 49201-1907
Phone
(517) 784-9101
Fax
(517) 796-3140
NPI assigned
Mar 26, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010790 MI Primary

Addresses

Primary practice location

610 W Michigan Ave
Jackson, MI 49201-1907

Mailing address

610 W Michigan Ave
Jackson, MI 49201-1907
Phone (517) 784-9101

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190729003302 MI Practitioner - Chiropractic 8426384405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Novo Chiropractic PLLCGroup PAC ID 5991087041, 7 clinicians

Practice addresses (Care Compare)

1851 44TH St SW N
Novo Chiropractic Wyoming
Wyoming, MI 49519-6440
Phone (616) 538-9880

5570 Wilson Ave SW
Suite MN
Wyoming, MI 49418-8867
Phone (616) 259-9835

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301010790MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Novo Chiropractic PLLC Chiropractor CurrentSince Jul 9, 2019 Accepting new patients
Balance GR Chiropractor Past Accepting new patients

Locations

5570 Wilson Ave SW
Ste L
Wyoming, MI 49418
Phone (616) 259-9835

1851 44th St SW
Ste N
Wyoming, MI 49519
Phone (616) 259-9835

5570 Wilson Ave SW
Ste Mn
Wyoming, MI 49418
Phone (616) 259-8935

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1553558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553558400000",
    "number": "1578024485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011907",
            "telephone_number": "517-784-9101",
            "fax_number": "517-796-3140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011907",
            "telephone_number": "517-784-9101",
            "fax_number": "517-796-3140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILL",
        "first_name": "COLLEEN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-26",
        "last_updated": "2019-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010790",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.