Individual provider Active NPI

Brittany Marie Gregory, D.C.

  • Chiropractor
  • Wayland, MI
National Provider Identifier
1750657086
Registry record updated Sep 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012160 Issued in IL
Practice address
135 E Superior St
Wayland, MI 49348-1137
Phone
(269) 876-7814
Fax
(269) 792-6459
NPI assigned
Mar 30, 2012
Last updated
Sep 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 4, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012160 IL Primary

Addresses

Primary practice location

135 E Superior St
Wayland, MI 49348-1137

Mailing address

135 E Superior St
Wayland, MI 49348-1137
Phone (269) 876-7814

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130206000393 MI Practitioner - Chiropractic 5698929248 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Maple Lake ChiropracticGroup PAC ID 2163646399, 2 clinicians

Practice addresses (Care Compare)

109 W Michigan Ave
Paw Paw, MI 49079-1415
Phone (269) 655-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012160ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Maple Lake Chiropractic Chiropractor CurrentSince Apr 2, 2014 Accepting new patients
Full Potential Chiropractic, PC Chiropractor PastSince Mar 5, 2012 Accepting new patients

Locations

109 W Michigan Ave
Paw Paw, MI 49079
Phone (269) 655-2100

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": "1333065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346716800000",
    "number": "1750657086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 E SUPERIOR ST",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481137",
            "telephone_number": "269-876-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 E SUPERIOR ST",
            "city": "WAYLAND",
            "state": "MI",
            "postal_code": "493481137",
            "telephone_number": "269-876-7814",
            "fax_number": "269-792-6459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GREGORY",
        "first_name": "BRITTANY",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-30",
        "last_updated": "2012-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wayland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2012; 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.