Vibrant Life Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010511 Issued in MI

Legal business name

VIBRANT LIFE CHIROPRACTIC LLC

Practice address

1971 E Beltline Ave NE
Suite 126
Grand Rapids, MI 49525-7045

Phone

(616) 855-2017

Fax

(616) 828-1904

NPI assigned

Jan 19, 2017

Last updated

Jan 19, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Kurt Lang, DCNPI 1730626466

Title

Owner

Phone

(616) 855-2017

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Kurt Lang, DC

  • Chiropractor
  • Grand Rapids, MI
  • NPI 1730626466
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1484784000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484784000000",
    "number": "1811434541",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1971 E BELTLINE AVE NE",
            "address_2": "SUITE 126",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257045",
            "telephone_number": "616-855-2017",
            "fax_number": "616-828-1904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1971 E BELTLINE AVE NE",
            "address_2": "SUITE 126",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495257045",
            "telephone_number": "616-855-2017",
            "fax_number": "616-828-1904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIBRANT LIFE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-01-19",
        "last_updated": "2017-01-19",
        "status": "A",
        "authorized_official_last_name": "LANG",
        "authorized_official_first_name": "KURT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "616-855-2017",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010511",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2017; 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.