Organization Active NPI

Crossroads Chiropractic, PLLC

Doing business as Crossroads Chiropractic

  • Chiropractor
  • Cement City, MI
National Provider Identifier
1619733763
Registry record updated Apr 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CROSSROADS CHIROPRACTIC, PLLC
Doing business as
Crossroads Chiropractic
Practice address
18875 E Chicago Rd
Cement City, MI 49233-9005
Phone
(517) 442-4805
NPI assigned
Feb 26, 2024
Last updated
Apr 16, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2024

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

Authorized official

Name
Jordan Lincoln Bach, DCNPI 1942965728
Title
Owner
Phone
(517) 740-5485

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

18875 E Chicago Rd
Cement City, MI 49233-9005

Mailing address

18875 E Chicago Rd
Cement City, MI 49233-9005
Phone (517) 740-5485

Other names 1

  • Crossroads Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240503001921 MI Part B Supplier - Clinic/Group Practice 8921448234 Receives reassigned benefits from 1 practitioner
Practice locations: Cement City, MI

National Provider Directory

National Provider Directory

Locations

18875 E Chicago Rd
Cement City, MI 49233
Phone (517) 442-4805

Practitioners & affiliated clinicians

Practitioners 2

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": "1708905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1713225600000",
    "number": "1619733763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18875 E CHICAGO RD",
            "city": "CEMENT CITY",
            "state": "MI",
            "postal_code": "492339005",
            "telephone_number": "517-740-5485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18875 E CHICAGO RD",
            "city": "CEMENT CITY",
            "state": "MI",
            "postal_code": "492339005",
            "telephone_number": "517-442-4805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROSSROADS CHIROPRACTIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-26",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-12",
        "status": "A",
        "authorized_official_last_name": "BACH",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "LINCOLN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-740-5485",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cement City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.