NPIMap

Organization Active NPI

Shift Chiropractic, PLC

  • Chiropractor
  • Traverse City, MI
National Provider Identifier
1770087199
Registry record updated Jan 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SHIFT CHIROPRACTIC, PLC
Practice address
2400 Northern Visions Dr
Traverse City, MI 49684-7034
Phone
(231) 846-8897
NPI assigned
Mar 20, 2018
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Dr. Kyle William Konas, DCNPI 1144724550
Title
Owner
Phone
(231) 499-6858

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Practitioners 8

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20180927001705 MI Part B Supplier - Clinic/Group Practice 6608127808 Receives reassigned benefits from 4 practitioners
Practice locations: Traverse City, MI

National Provider Directory

National Provider Directory

Locations

3055 Cass Rd
Ste 102B
Traverse City, MI 49684
Phone (231) 846-8897

2400 Northern Visions Dr
Traverse City, MI 49684
Phone (231) 846-8897

Specialties & licenses 1

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

Addresses

NPPES NPI Registry

Primary practice location

2400 Northern Visions Dr
Traverse City, MI 49684-7034

Mailing address

2400 Northern Visions Dr
Traverse City, MI 49684-7034
Phone (231) 846-8897

Other names 1

NPPES NPI Registry
  • Shift Chiropractic Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 12, 2023.

{
    "created_epoch": "1521504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673481600000",
    "number": "1770087199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 NORTHERN VISIONS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847034",
            "telephone_number": "231-846-8897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 NORTHERN VISIONS DR",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496847034",
            "telephone_number": "231-846-8897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHIFT CHIROPRACTIC, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-20",
        "last_updated": "2023-01-12",
        "certification_date": "2023-01-12",
        "status": "A",
        "authorized_official_last_name": "KONAS",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "231-499-6858",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Shift Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Traverse City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2023; 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.