Organization Active NPI

Big Vision, LLC

  • Chiropractor
  • Jackson, MI
National Provider Identifier
1689784126
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BIG VISION, LLC
Practice address
1211 Warren Ave
Jackson, MI 49203-3729
Phone
(517) 990-0555
Fax
(517) 990-0550
NPI assigned
Aug 30, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Authorized official

Name
Brad Allen Double, DCNPI 1871609594
Title
Owner
Phone
(517) 458-7141

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1211 Warren Ave
Jackson, MI 49203-3729

Mailing address

1211 Warren Ave
Jackson, MI 49203-3729
Phone (517) 990-0555

Other identifiers 1

IdentifierTypeStateIssuer
0D61058OtherMIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040625001010 MI Part B Supplier - Clinic/Group Practice 8022094473 Receives reassigned benefits from 1 practitioner
Practice locations: Jackson, MI; Morenci, MI

National Provider Directory

National Provider Directory

Locations

1211 Warren Ave
Jackson, MI 49203
Phone (517) 900-0555

113 W Main St
Morenci, MI 49256
Phone (517) 458-7141

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655424000000",
    "number": "1689784126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 WARREN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033729",
            "telephone_number": "517-990-0555",
            "fax_number": "517-990-0550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 WARREN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492033729",
            "telephone_number": "517-990-0555",
            "fax_number": "517-990-0550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIG VISION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-30",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A",
        "authorized_official_last_name": "DOUBLE",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "517-458-7141",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0D61058",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.