Individual provider Active NPI

Robert Jay Koliner, D.C.

  • Chiropractor
  • Ann Arbor, MI
National Provider Identifier
1689730699
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301006146 Issued in MI
Practice address
210 Little Lake Dr Ste 8
Ann Arbor, MI 48103-6218
Phone
(734) 761-5908
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 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 2301006146 MI Primary

Addresses

Primary practice location

210 Little Lake Dr Ste 8
Ann Arbor, MI 48103-6218

Mailing address

210 Little Lake Dr Ste 8
Ann Arbor, MI 48103-6218
Phone (734) 761-5908

Other identifiers 1

IdentifierTypeStateIssuer
95OH152470OtherMIBC-BS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081023000072 MI Practitioner - Chiropractic 5799843579 Practice locations: Ann Arbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

210 Little Lake Dr
Ann Arbor, MI 48103-6218
Phone (734) 761-5908

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301006146MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Nutrition and Chiropractic PLLC Chiropractor Past Accepting new patients
Sacred Healing Therapeutic Services LLC Past Accepting new patients

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689730699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 LITTLE LAKE DR STE 8",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036218",
            "telephone_number": "734-761-5908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 LITTLE LAKE DR STE 8",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481036218",
            "telephone_number": "734-761-5908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOLINER",
        "first_name": "ROBERT",
        "middle_name": "JAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006146",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC-BS",
            "identifier": "95OH152470",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.