Individual provider Active NPI

Raymond Dexter Sanders, D.C.

  • Chiropractor
  • Grand Haven, MI
National Provider Identifier
1679535512
Registry record updated Aug 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
RS008001 Issued in MI
Practice address
635 Fulton St
Grand Haven, MI 49417-1237
Phone
(616) 842-9411
Fax
(616) 842-9058
NPI assigned
Apr 5, 2006
Last updated
Aug 10, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X RS008001 MI Primary

Addresses

Primary practice location

635 Fulton St
Grand Haven, MI 49417-1237

Mailing address

635 Fulton St
Grand Haven, MI 49417-1237
Phone (616) 842-9411

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RS008001MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Peterson Chiropractic, PC Chiropractor PastSince Mar 13, 2017 Accepting new patients
Great Lakes Chiropractic Health Chiropractor Past Accepting new patients
Chiro-Technology PC Chiropractor PastSince Nov 20, 2014 Accepting new patients
Klapp Chiropractic Life Center, LLC Chiropractor PastSince Jun 21, 2016 Accepting new patients

Organizations & group practices 5

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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249862400000",
    "number": "1679535512",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "635 FULTON ST",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171237",
            "telephone_number": "616-842-9411",
            "fax_number": "616-842-9058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "635 FULTON ST",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494171237",
            "telephone_number": "616-842-9411",
            "fax_number": "616-842-9058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDERS",
        "first_name": "RAYMOND",
        "middle_name": "DEXTER",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-05",
        "last_updated": "2009-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "RS008001",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.