Individual provider Active NPI

Randy D Brown, DC

  • Chiropractor
  • Whitehall, MI
National Provider Identifier
1851373146
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301003057 Issued in MI
Practice address
1020 S Mears Ave
Whitehall, MI 49461-1729
Phone
(231) 893-1755
Fax
(231) 893-3595
NPI assigned
Nov 14, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301003057 MI Primary

Addresses

Primary practice location

1020 S Mears Ave
Whitehall, MI 49461-1729

Mailing address

1020 S Mears Ave
Whitehall, MI 49461-1729
Phone (231) 893-1755

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090706000209 MI Practitioner - Chiropractic 0042361966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1979
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1030 S Mears Ave
A
Whitehall, MI 49461-1779
Phone (231) 893-1755

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
White Lake Chiropractic Centre Inc Chiropractor CurrentSince Jul 12, 1979 Accepting new patients

Locations

1020 S Mears Ave
Whitehall, MI 49461
Phone (231) 893-1755

1030 S Mears Ave
Whitehall, MI 49461
Phone (231) 893-1755

1030 S Mears Ave
Ste A
Whitehall, MI 49461
Phone (231) 893-1755

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1131926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851373146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1020 S MEARS AVE",
            "city": "WHITEHALL",
            "state": "MI",
            "postal_code": "494611729",
            "telephone_number": "231-893-1755",
            "fax_number": "231-893-3595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 S MEARS AVE",
            "city": "WHITEHALL",
            "state": "MI",
            "postal_code": "494611729",
            "telephone_number": "231-893-1755",
            "fax_number": "231-893-3595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "RANDY",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301003057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Whitehall, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.