Individual provider Active NPI

Wyatt Parker Drost, DC

  • Chiropractor
  • Charlevoix, MI
National Provider Identifier
1902470917
Registry record updated May 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301401294 Issued in MI
Practice address
1422 Bridge St
Charlevoix, MI 49720-1610
Phone
(231) 373-4345
NPI assigned
May 14, 2021
Last updated
May 4, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CHR.0008196 CO
Chiropractor 111N00000X 2301401294 MI Primary

Addresses

Primary practice location

1422 Bridge St
Charlevoix, MI 49720-1610

Mailing address

1422 Bridge St
Charlevoix, MI 49720-1610
Phone (231) 373-4345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230802002207 MI Practitioner - Chiropractic 0648679829 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Innate Wisdom, PLC Chiropractor CurrentSince Oct 23, 2024 Accepting new patients
Village Chiropractic Wellness Center, PLC Chiropractor CurrentSince Nov 18, 2023 Accepting new patients
Advanced Dermatology of Michigan PC Past Accepting new patients

Locations

9060 N Bayshore Dr
Elk Rapids, MI 49629

798 W Mile Rd NW
Kalkaska, MI 49646
Phone (231) 258-4023

9995 Rapid City Rd NW
Rapid City, MI 49676
Phone (231) 331-7010

Organizations & group practices 4

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": "1620950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683158400000",
    "number": "1902470917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1422 BRIDGE ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201610",
            "telephone_number": "231-373-4345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1422 BRIDGE ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201610",
            "telephone_number": "231-373-4345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DROST",
        "first_name": "WYATT",
        "middle_name": "PARKER",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-14",
        "last_updated": "2023-05-04",
        "certification_date": "2023-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CHR.0008196",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2023; 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.