NPIMap

Organization Active NPI

Peak Performance Integrated Medicine, PLC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1932250693
Registry record updated Nov 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PEAK PERFORMANCE INTEGRATED MEDICINE, PLC
Practice address
4150 E Beltline Ave NE
Suite #3
Grand Rapids, MI 49525-9316
Phone
(616) 447-9888
Fax
(616) 447-9886
NPI assigned
Jan 16, 2007
Last updated
Nov 13, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2023

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

Authorized official

Name
Ms. Andrea R Smith
Title
Operations Manager
Phone
(616) 447-8888

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X
Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363L00000X

Addresses

Primary practice location

4150 E Beltline Ave NE
Suite #3
Grand Rapids, MI 49525-9316

Mailing address

4150 E Beltline Ave NE
Suite #3
Grand Rapids, MI 49525-9316
Phone (616) 447-9888

Other names 1

  • Peak Performance Chiropractic PLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070117000242 MI Part B Supplier - Clinic/Group Practice 7012918196 Receives reassigned benefits from 7 practitioners
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

6690 Crossings Dr SE
Ste A
Grand Rapids, MI 49508
Phone (616) 656-1830

6750 Kalamazoo Ave SE
Ste K
Grand Rapids, MI 49508
Phone (616) 447-9888

4150 E Beltline Ave NE
Ste 3
Grand Rapids, MI 49525
Phone (616) 447-9888

Practitioners & affiliated clinicians

Practitioners 9

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1932250693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4150 E BELTLINE AVE NE",
            "address_2": "SUITE #3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259316",
            "telephone_number": "616-447-9888",
            "fax_number": "616-447-9886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4150 E BELTLINE AVE NE",
            "address_2": "SUITE #3",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259316",
            "telephone_number": "616-447-9888",
            "fax_number": "616-447-9886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEAK PERFORMANCE INTEGRATED MEDICINE, PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "616-447-8888",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peak Performance Chiropractic PLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

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