Brandon Weaver, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

L644335 Issued in MI

Practice address

1302 Bridge St
Charlevoix, MI 49720-1608

Phone

(231) 237-0665

NPI assigned

Feb 6, 2015

Last updated

Feb 6, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Western States College of Chiropractic, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeshore Chiropractic and Sports Rehabilitation PLLCGroup PAC ID 1658624937, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Lakeshore Chiropractic and Sports Rehabilitation PLLC

  dba Randall Chiropractic Clinic

  • Chiropractor
  • Charlevoix, MI
  • NPI 1184881344
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1423180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1423180800000",
    "number": "1801287222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "570 E MAIN ST",
            "city": "GAYLORD",
            "state": "MI",
            "postal_code": "497351344",
            "telephone_number": "515-975-3678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1302 BRIDGE ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201608",
            "telephone_number": "231-237-0665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEAVER",
        "first_name": "BRANDON",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-02-06",
        "last_updated": "2015-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "L644335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Vollmer, LPC
• Alexandra Bokor Waha, LMSW
• Walgreen Co (Walgreens #12508)
• Ernest Walker, PA-C
• Lisa Ward, LICENSED PTA
• Emmaline Weidman, PH.D
• Andrew John Weise, M.D.
• Casey Thomas Weitzel, PA-C
• Rebecca A Weldon, OTR
• Tory Werth, CADC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2015; 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.