Organization Active NPI

Clear Connections Chiropractic PLLC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1750676409
Registry record updated Jul 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009827 Issued in MI
Legal business name
CLEAR CONNECTIONS CHIROPRACTIC PLLC
Practice address
1500 E Beltline Ave SE
Suite 145
Grand Rapids, MI 49506-4361
Phone
(616) 608-3606
Fax
(616) 551-3233
NPI assigned
Jun 10, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2011

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

Authorized official

Name
Krystal Czegus, D.C.
Title
Owner/Chiropractor
Phone
(586) 255-2772

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301009827 MI Primary

Addresses

Primary practice location

1500 E Beltline Ave SE
Suite 145
Grand Rapids, MI 49506-4361

Mailing address

1500 E Beltline Ave SE
Suite 145
Grand Rapids, MI 49506-4361
Phone (616) 608-3606

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110818000145 MI Part B Supplier - Clinic/Group Practice 1153590617 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

1500 E Beltline Ave SE
Ste 145
Grand Rapids, MI 49506
Phone (616) 608-3606

2000 32nd St SE
Grand Rapids, MI 49508
Phone (616) 245-1600

Practitioners & affiliated clinicians

Practitioners 1

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": "1307664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1311897600000",
    "number": "1750676409",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1500 E BELTLINE AVE SE",
            "address_2": "SUITE 145",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064361",
            "telephone_number": "616-608-3606",
            "fax_number": "616-551-3233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E BELTLINE AVE SE",
            "address_2": "SUITE 145",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495064361",
            "telephone_number": "616-608-3606",
            "fax_number": "616-551-3233"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLEAR CONNECTIONS CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-10",
        "last_updated": "2011-07-29",
        "status": "A",
        "authorized_official_last_name": "CZEGUS",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "586-255-2772",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2011; 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.