Individual provider Active NPI

Charles Matthew Gilcher, D.C.

  • Chiropractor
  • Lincoln Park, MI
National Provider Identifier
1992793905
Registry record updated Dec 9, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301006168 Issued in MI
Practice address
3030 Fort St
Lincoln Park, MI 48146-2428
Phone
(313) 928-2777
Fax
(313) 928-2825
NPI assigned
Oct 12, 2005
Last updated
Dec 9, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 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 2301006168 MI Primary

Addresses

Primary practice location

3030 Fort St
Lincoln Park, MI 48146-2428

Mailing address

3030 Fort St
Lincoln Park, MI 48146-2428
Phone (313) 928-2777

Other identifiers 5

IdentifierTypeStateIssuer
143224525MedicaidMI
950H234910OtherMIBCBSM
U51766OtherMIHAP
383277909OtherMICOMMERCIAL
950H253200OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040220000415 MI Practitioner - Chiropractic 6709771694 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3030 Fort St
Lincoln Park, MI 48146-2428
Phone (313) 928-2777

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Charles M. Gilcher D.C., P.C. Chiropractor CurrentSince Mar 1, 2004 Accepting new patients

Locations

3030 Fort St
Lincoln Park, MI 48146
Phone (313) 928-2777

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1323388800000",
    "number": "1992793905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3030 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462428",
            "telephone_number": "313-928-2777",
            "fax_number": "313-928-2825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 FORT ST",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481462428",
            "telephone_number": "313-928-2777",
            "fax_number": "313-928-2825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILCHER",
        "first_name": "CHARLES",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-12",
        "last_updated": "2011-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301006168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "143224525",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "950H234910",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "U51766",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMERCIAL",
            "identifier": "383277909",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "950H253200",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, MI

Sources for this page

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