Individual provider Active NPI

Aaron Lee Rackham, D.C.

  • Chiropractor
  • Greenville, MI
National Provider Identifier
1902865504
Registry record updated Aug 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301005984 Issued in MI
Practice address
9396 SW Greenville Rd
Greenville, MI 48838-9445
Phone
(616) 754-7717
Fax
(616) 754-7791
NPI assigned
Mar 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 13, 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 2301005984 MI Primary

Addresses

Primary practice location

9396 SW Greenville Rd
Greenville, MI 48838-9445

Mailing address

9396 SW Greenville Rd
Greenville, MI 48838-9445
Phone (616) 754-7717

Other identifiers 2

IdentifierTypeStateIssuer
2910050MedicaidMI
950E910580OtherMIBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511000937 MI Practitioner - Chiropractic 0345138707 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Los Angeles, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9396 SW Greenville Rd
Greenville, MI 48838-9445
Phone (616) 754-7717

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Caro Chiropractic PC Chiropractor PastSince Apr 22, 2021 Accepting new patients
Chiropractic Wellness Center of Caro PLLC Chiropractor PastSince May 6, 2017 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1142985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344816000000",
    "number": "1902865504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9396 SW GREENVILLE RD",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488389445",
            "telephone_number": "616-754-7717",
            "fax_number": "616-754-7791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9396 SW GREENVILLE RD",
            "city": "GREENVILLE",
            "state": "MI",
            "postal_code": "488389445",
            "telephone_number": "616-754-7717",
            "fax_number": "616-754-7791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKHAM",
        "first_name": "AARON",
        "middle_name": "LEE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-22",
        "last_updated": "2012-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301005984",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2910050",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "950E910580",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.