Individual provider Active NPI

Corrina Shampo, DC

  • Chiropractor
  • Kingsford, MI
National Provider Identifier
1952902504
Registry record updated Jun 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301011009 Issued in MI
Practice address
1205 Pyle Dr
Kingsford, MI 49802-1132
Phone
(906) 828-1349
NPI assigned
Nov 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301011009 MI Primary

Addresses

Primary practice location

1205 Pyle Dr
Kingsford, MI 49802-1132

Mailing address

1205 Pyle Dr
Kingsford, MI 49802-1132
Phone (906) 828-1349

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201119002839 MI Practitioner - Chiropractic 1658782800 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1205 Pyle Dr
Kingsford, MI 49802-1132
Phone (906) 828-1349

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301011009MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Corrina Chiropractic PLLC Chiropractor CurrentSince Jun 7, 2024 Accepting new patients

Locations

1205 Pyle Dr
Kingsford, MI 49802
Phone (906) 779-7100

Organizations & group practices 1

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": "1604275200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717718400000",
    "number": "1952902504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1205 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498021132",
            "telephone_number": "906-828-1349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 PYLE DR",
            "city": "KINGSFORD",
            "state": "MI",
            "postal_code": "498021132",
            "telephone_number": "906-828-1349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMPO",
        "first_name": "CORRINA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-02",
        "last_updated": "2024-06-07",
        "certification_date": "2024-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301011009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingsford, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2024; 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.