Individual provider Active NPI

Edwin Richard Kaput, D.C.

  • Chiropractor
  • Clio, MI
National Provider Identifier
1861767238
Registry record updated Mar 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009884 Issued in MI
Practice address
5092 W Vienna Rd
Suite H
Clio, MI 48420-2803
Phone
(586) 604-3253
Fax
(810) 686-3124
NPI assigned
Mar 18, 2012
Last updated
Mar 18, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009884 MI Primary

Addresses

Primary practice location

5092 W Vienna Rd
Suite H
Clio, MI 48420-2803

Mailing address

5092 W Vienna Rd
Suite H
Clio, MI 48420-2803
Phone (586) 604-3253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130326000371 MI Practitioner - Chiropractic 8729223664 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

21880 23 Mile Rd
Macomb, MI 48042-4422
Phone (586) 949-0500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Genesis Chiropractic PLLC Chiropractor CurrentSince Mar 12, 2013 Accepting new patients
Sather Chiropractic PLC Chiropractor PastSince May 22, 2015 Accepting new patients

Locations

21880 23 Mile Rd
Macomb, MI 48042
Phone (586) 604-3253

Organizations & group practices 2

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": "1332028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332028800000",
    "number": "1861767238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5092 W VIENNA RD",
            "address_2": "SUITE H",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484202803",
            "telephone_number": "586-604-3253",
            "fax_number": "810-686-3124"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5092 W VIENNA RD",
            "address_2": "SUITE H",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484202803",
            "telephone_number": "586-604-3253",
            "fax_number": "810-686-3124"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAPUT",
        "first_name": "EDWIN",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-18",
        "last_updated": "2012-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clio, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2012; 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.