Impact Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

IMPACT CHIROPRACTIC PC

Practice address

2837 Stable Dr Ste B
Kimball, MI 48074-1441

Phone

(810) 432-8829

Fax

(810) 432-8837

NPI assigned

Jun 15, 2022

Last updated

Jun 15, 2022By 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. Travis Grace, DCNPI 1124505656

Title

Owner

Phone

(810) 432-8829

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.

• Travis Grace, DC

  • Chiropractor
  • Kimball, MI
  • NPI 1124505656
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1655251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655251200000",
    "number": "1851021448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2837 STABLE DR STE B",
            "city": "KIMBALL",
            "state": "MI",
            "postal_code": "480741441",
            "telephone_number": "810-432-8829",
            "fax_number": "810-432-8837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2837 STABLE DR STE B",
            "city": "KIMBALL",
            "state": "MI",
            "postal_code": "480741441",
            "telephone_number": "810-432-8829",
            "fax_number": "810-432-8837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMPACT CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-15",
        "last_updated": "2022-06-15",
        "certification_date": "2022-06-15",
        "status": "A",
        "authorized_official_last_name": "GRACE",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "810-432-8829",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Ann Gemmete
• Travis Grace, DC
• Jessica Dawn Harris
• Karen J Hennesey, RPH
• Audrey Christine Hollen
• Gary A James, D.O.
• Renee Jankowski, FNP-C
• Kimball Family Dental
• Bailey Christine Klein, DMD
• Sherri Ann Lester, CPHT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2022; 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.