Individual provider Active NPI

Rosamond C Soanes, D.C.

  • Chiropractor
  • Niles, MI
National Provider Identifier
1659464295
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007398 Issued in MI
Practice address
2028 S 11TH Street
Niles, MI 49120
Phone
(269) 683-1700
Fax
(269) 683-7038
NPI assigned
Oct 2, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007398 MI Primary

Addresses

Primary practice location

2028 S 11TH Street
Niles, MI 49120

Mailing address

2028 S 11TH Street
Niles, MI 49120
Phone (269) 683-1700

Other identifiers 1

IdentifierTypeStateIssuer
P00175180OtherMIRR MEDICARE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040512001371 MI Practitioner - Chiropractic 6305836461 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2714 S 11TH St
Suite a
Niles, MI 49120-4761
Phone (269) 683-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Berrien Family Chiropractic, Inc. Chiropractor CurrentSince Jan 1, 2005 Accepting new patients
Mary Patricia McManmon MD PC Chiropractor Past Accepting new patients

Locations

9046 US Highway 31
Ste 2
Berrien Springs, MI 49103
Phone (269) 471-3006

1036 Bell Rd
Niles, MI 49120
Phone (269) 683-1700

2028 S 11th St
Niles, MI 49120
Phone (269) 683-1700

2714 S 11th St
Ste A
Niles, MI 49120
Phone (269) 683-1700

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1659464295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2028 S 11TH STREET",
            "city": "NILES",
            "state": "MI",
            "postal_code": "49120",
            "telephone_number": "269-683-1700",
            "fax_number": "269-683-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 S 11TH STREET",
            "city": "NILES",
            "state": "MI",
            "postal_code": "49120",
            "telephone_number": "269-683-1700",
            "fax_number": "269-683-7038"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOANES",
        "first_name": "ROSAMOND",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007398",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE NUMBER",
            "identifier": "P00175180",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Niles, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.