Individual provider Active NPI

Megan Renee Gotham, DC

  • Chiropractor
  • Portage, MI
National Provider Identifier
1972293215
Registry record updated Dec 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301401421 Issued in MI
Practice address
8175 Creekside Dr Ste 110
Portage, MI 49024-5370
Phone
(269) 324-5000
Fax
(269) 324-5822
NPI assigned
May 10, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301401421 MI Primary

Addresses

Primary practice location

8175 Creekside Dr Ste 110
Portage, MI 49024-5370

Mailing address

8175 Creekside Dr Ste 110
Portage, MI 49024-5370
Phone (269) 324-5000

Other names 1

  • Megan Gotham Mattox Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230718003936 MI Practitioner - Chiropractic 9638539935 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Express Your Health LLCGroup PAC ID 6204852254, 2 clinicians

Practice addresses (Care Compare)

8175 Creekside Dr
Suite 110
Portage, MI 49024-5370
Phone (269) 324-5000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301401421MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Express Your Health LLC Chiropractor CurrentSince Sep 16, 2024 Accepting new patients

Locations

8175 Creekside Dr
Ste 110
Portage, MI 49024
Phone (269) 248-1006

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": "1683676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766707200000",
    "number": "1972293215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8175 CREEKSIDE DR STE 110",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245370",
            "telephone_number": "269-324-5000",
            "fax_number": "269-324-5822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8175 CREEKSIDE DR STE 110",
            "city": "PORTAGE",
            "state": "MI",
            "postal_code": "490245370",
            "telephone_number": "269-324-5000",
            "fax_number": "269-324-5822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOTHAM",
        "first_name": "MEGAN",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-10",
        "last_updated": "2025-12-26",
        "certification_date": "2025-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401421",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MEGAN",
            "last_name": "GOTHAM MATTOX",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portage, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2025; 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.