Active NPI
Maurice Ashley Sampedro, D.C.
- Chiropractor
- Kentwood, MI
National Provider Identifier
1942289525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301009095
- Practice address
- 5260 Kalamazoo Ave SE
Kentwood, MI 49508-6131 - Phone
- (616) 827-2350
- NPI assigned
- Jan 12, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301009095 | MI | Primary |
Addresses
Primary practice location
5260 Kalamazoo Ave SE
Kentwood, MI 49508-6131
Mailing address
5260 Kalamazoo Ave SE
Kentwood, MI 49508-6131
Phone (616) 581-7119
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1145 Washington Ave
Suite D
Holland, MI 49423-5296
Phone (616) 396-9940
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301009095 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Good Life Chiropractic Inc. | Chiropractor | Current | Accepting new patients |
| Natural Choice Chiropractic LLC | Chiropractor | Past | Accepting new patients |
Locations
1145 Washington Ave
Ste D
Holland, MI 49423
Phone (616) 396-9940
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 and National Provider Directory roles.
-
- Chiropractor
- Holland, MI
- NPI 1942590252
-
- Chiropractor
- Kentwood, MI
- NPI 1649484403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1205280000000",
"number": "1942289525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5260 KALAMAZOO AVE SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495086131",
"telephone_number": "616-581-7119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5260 KALAMAZOO AVE SE",
"city": "KENTWOOD",
"state": "MI",
"postal_code": "495086131",
"telephone_number": "616-827-2350"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SAMPEDRO",
"first_name": "MAURICE",
"middle_name": "ASHLEY",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-12",
"last_updated": "2008-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301009095",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Kentwood, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2008; 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.