Individual provider Active NPI

Brian J. Kulbieda, D.C.

  • Chiropractor
  • Marquette, MI
National Provider Identifier
1962407403
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
BK008347 Issued in MI
Practice address
1300 W Ridge St Ste 1
Marquette, MI 49855-3194
Phone
(906) 226-3663
Fax
(906) 226-2956
NPI assigned
Jun 20, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X BK008347 MI Primary

Addresses

Primary practice location

1300 W Ridge St Ste 1
Marquette, MI 49855-3194

Mailing address

1300 W Ridge St Ste 1
Marquette, MI 49855-3194
Phone (906) 226-3663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060501000303 MI Practitioner - Chiropractic 3779593199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1300 W Ridge St
Suite 1
Marquette, MI 49855-2142
Phone (906) 226-3663

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
BK008347MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Axis Chiropractic P.C. Chiropractor CurrentSince May 1, 2006 Accepting new patients

Locations

1300 W Ridge St
Ste 1
Marquette, MI 49855
Phone (906) 226-3663

Interoperability endpoints

  • Direct secure messaging: bjk0629@acp0008.direct.chirotouch.md

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1962407403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W RIDGE ST STE 1",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553194",
            "telephone_number": "906-226-3663",
            "fax_number": "906-226-2956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 W RIDGE ST STE 1",
            "city": "MARQUETTE",
            "state": "MI",
            "postal_code": "498553194",
            "telephone_number": "906-226-3663",
            "fax_number": "906-226-2956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KULBIEDA",
        "first_name": "BRIAN",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-20",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "BK008347",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marquette, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.