Individual provider Active NPI

Robert Lyle Buckhannon DC, DC

  • Chiropractor
  • Battle Creek, MI
National Provider Identifier
1891054722
Registry record updated May 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301006570 Issued in MI
Practice address
2846 Capital Ave SW
Battle Creek, MI 49015-4106
Phone
(126) 983-0984
NPI assigned
May 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 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 2301006570 MI Primary

Addresses

Primary practice location

2846 Capital Ave SW
Battle Creek, MI 49015-4106

Mailing address

200 Wahwahtaysee Way
Battle Creek, MI 49015-4061
Phone (126) 983-0984

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2301006570MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1336780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336780800000",
    "number": "1891054722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 WAHWAHTAYSEE WAY",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490154061",
            "telephone_number": "126-983-0984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2846 CAPITAL AVE SW",
            "city": "BATTLE CREEK",
            "state": "MI",
            "postal_code": "490154106",
            "telephone_number": "126-983-0984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUCKHANNON DC",
        "first_name": "ROBERT",
        "middle_name": "LYLE",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-12",
        "last_updated": "2012-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Creek, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.