Individual provider Active NPI

William John Golas, DC

  • Chiropractor
  • Benton Harbor, MI
National Provider Identifier
1952329005
Registry record updated Oct 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301006669 Issued in MI
Practice address
1404 E Napier Ave
Benton Harbor, MI 49022-2136
Phone
(269) 926-8213
Fax
(269) 926-8215
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 6, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301006669 MI Primary

Addresses

Primary practice location

1404 E Napier Ave
Benton Harbor, MI 49022-2136

Mailing address

64060 66TH Ave
Hartford, MI 49057-9692
Phone (269) 208-3122

Other identifiers 2

IdentifierTypeStateIssuer
950A15030OtherMIBLUE CROSS BLUE SHIELD
3268816MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111130000204 MI Practitioner - Chiropractic 6800060989 Practice locations: Decatur, MI; Benton Harbor, MI

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1404 E Napier Ave
Benton Harbor, MI 49022-2136
Phone (269) 926-8213

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301006669MIMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317859200000",
    "number": "1952329005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64060 66TH AVE",
            "city": "HARTFORD",
            "state": "MI",
            "postal_code": "490579692",
            "telephone_number": "269-208-3122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1404 E NAPIER AVE",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490222136",
            "telephone_number": "269-926-8213",
            "fax_number": "269-926-8215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLAS",
        "first_name": "WILLIAM",
        "middle_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2011-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006669",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950A15030",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3268816",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2011; 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.