Great Lakes Chiropractic & Movement PLLC

Primary specialty

Nutrition ChiropractorTaxonomy code 111NN1001X

License

2301009577 Issued in MI

Legal business name

GREAT LAKES CHIROPRACTIC & MOVEMENT PLLC

Practice address

4215 Miller Rd # A8
Flint, MI 48507-1299

Phone

(810) 234-5431

NPI assigned

Jul 18, 2018

Organization subpart

No

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

Authorized official

Name

Jon Dale Morey, DCNPI 1164653788

Title

Owner/Provider

Phone

(810) 234-5431

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 2

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

• Jon Dale Morey, D.C.

  • Nutrition Chiropractor
  • Flushing, MI
  • NPI 1164653788
  Medicare reassignment Authorized official
• Michael Edward Sparkman, DPT

  • Physical Therapist
  • Owosso, MI
  • NPI 1417414384
  NPD

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

{
    "created_epoch": "1531872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1555372800000",
    "number": "1720564149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4215 MILLER RD # A8",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071299",
            "telephone_number": "810-234-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4215 MILLER RD # A8",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485071299",
            "telephone_number": "810-234-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT LAKES CHIROPRACTIC & MOVEMENT PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-18",
        "last_updated": "2019-04-16",
        "status": "A",
        "authorized_official_last_name": "MOREY",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "810-234-5431",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Nutrition",
            "state": "MI",
            "license": "2301009577",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "2301009577",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shawn Marie Gray, B.A.
• Sarah Ann Graybill, PA-C
• Kaisha Maran Grear
• Great Health Medical Mi PC
• Great Lakes Brain Spine Surgery and Pain Center PLLC
• Great Lakes Dental Services PLLC
• Great Lakes Interventional Pain Management,PLLC
• Great Lakes Oral Surgery and Implants, P.C.
• Great Lakes Orthotics and Prosthetics
• Great Lakes Pain & Rehab, PC

• Nutrition Chiropractor in Flint, MI
• Providers in Flint, MI by specialty
• Nutrition Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2019; 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.