Individual provider Active NPI

Kristin Satterly, DC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1649812033
Registry record updated Jul 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010886 Issued in MI
Practice address
2757 Leonard St NE Ste 200
Grand Rapids, MI 49525-5807
Phone
(806) 361-6458
NPI assigned
Oct 17, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010886 MI Primary

Addresses

Primary practice location

2757 Leonard St NE Ste 200
Grand Rapids, MI 49525-5807

Mailing address

13287 Jackson Rd
Lake Odessa, MI 48849-9595
Phone (616) 329-5333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191214000399 MI Practitioner - Chiropractic 3577996040 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Simple Truth Chiropractic PLLCGroup PAC ID 4880831817, 2 clinicians

Practice addresses (Care Compare)

1001 4TH Ave
Lake Odessa, MI 48849-1069
Phone (616) 278-0189

2757 Leonard St NE
Suite 200
Grand Rapids, MI 49525-5807
Phone (616) 458-8063

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301010886MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Simple Truth Chiropractic of Lake Odessa Chiropractor CurrentSince Apr 12, 2021 Accepting new patients
Simple Truth Chiropractic PLLC Chiropractor CurrentSince Nov 4, 2019 Accepting new patients
Simple Truth Chiropractic of Hastings Chiropractor PastSince Jun 30, 2024 Accepting new patients

Locations

2757 Leonard St NE
Ste 200
Grand Rapids, MI 49525
Phone (616) 458-8063

1001 4th Ave
Lake Odessa, MI 48849
Phone (616) 278-0189

Organizations & group practices 3

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": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1649812033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13287 JACKSON RD",
            "city": "LAKE ODESSA",
            "state": "MI",
            "postal_code": "488499595",
            "telephone_number": "616-329-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2757 LEONARD ST NE STE 200",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495255807",
            "telephone_number": "806-361-6458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SATTERLY",
        "first_name": "KRISTIN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-17",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010886",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.