Lakeshore Chiropractic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301007774 Issued in MI

Legal business name

LAKESHORE CHIROPRACTIC, INC.

Practice address

1838 Baldwin St
Jenison, MI 49428-8901

Phone

(616) 301-1702

Fax

(616) 301-1708

NPI assigned

Apr 21, 2010

Organization subpart

No

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

Authorized official

Name

Dr. David John Estefan, D.C.NPI 1477508174

Title

President

Phone

(616) 301-1702

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Practitioners 2

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

• David John Estefan, D.C.

  • Chiropractor
  • Jenison, MI
  • NPI 1477508174
  Medicare reassignment Care Compare group NPD Authorized official
• Matthew Wiersma, DC

  • Chiropractor
  • Jenison, MI
  • NPI 1588115786
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1271808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1357776000000",
    "number": "1770800443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1838 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288901",
            "telephone_number": "616-301-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 BALDWIN ST",
            "city": "JENISON",
            "state": "MI",
            "postal_code": "494288901",
            "telephone_number": "616-301-1702",
            "fax_number": "616-301-1708"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKESHORE CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-21",
        "last_updated": "2013-01-10",
        "status": "A",
        "authorized_official_last_name": "ESTEFAN",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-301-1702",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Lynn Kroeger, PHD
• Martin Robert Kugel Jr, RPH
• Kaila Ann Kulczyski
• Stephanie Ann Laidlaw
• Jennifer Marie Lake, PMHNP
• Lakeshore Guidance LLC
• David Laman, PH.D.
• Amanda Lane
• Renee Lanning, RN
• Joann Lee, DDS

• Chiropractor in Jenison, MI
• Providers in Jenison, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2013; 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.