Individual provider Active NPI

Anthony Edward Trombly, DC

  • Chiropractor
  • Lowell, MI
National Provider Identifier
1770628349
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301002268 Issued in MI
Practice address
2230 W Main St
Lowell, MI 49331-9504
Phone
(616) 987-4445
Fax
(616) 987-4440
NPI assigned
Feb 21, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301002268 MI Primary

Addresses

Primary practice location

2230 W Main St
Lowell, MI 49331-9504

Mailing address

2230 W Main St
Lowell, MI 49331-9504
Phone (616) 987-4445

Other identifiers 2

IdentifierTypeStateIssuer
950D150750OtherMIBLUE CROSS & BLUE SHEILD
4304102MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120404000579 MI Practitioner - Chiropractic 7810093705 Practice locations: Lowell, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2230 W Main St
Lowell, MI 49331-9504
Phone (616) 987-4445

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301002268MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1318464000000",
    "number": "1770628349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2230 W MAIN ST",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493319504",
            "telephone_number": "616-987-4445",
            "fax_number": "616-987-4440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 W MAIN ST",
            "city": "LOWELL",
            "state": "MI",
            "postal_code": "493319504",
            "telephone_number": "616-987-4445",
            "fax_number": "616-987-4440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROMBLY",
        "first_name": "ANTHONY",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2011-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301002268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS & BLUE SHEILD",
            "identifier": "950D150750",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4304102",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lowell, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.