DR. KENNETH ROBERT TILLER (NPI# 1093801201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1093801201 |
| Entity Type | Individual |
| Full Name | DR. KENNETH ROBERT TILLER |
| Credential | DC |
| Practice Address |
7890 Main Birch Run MI 48415 |
| Mailing Address |
Po Box 399 7890 Main Birch Run MI 48415 |
| Practice Telephone | 9896246266 |
| Practice Fax Number | 9896244407 |
| Mailing Telephone | 9896246266 |
| Mailing Fax Number | 9896244407 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-07-12 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 2301005216 | MI | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS | 950G35246 | 01 |
| MI | 2928135 | 05 | |
| MI | AETNA | 391945651 | 01 |
| Street Address |
7890 MAIN |
| City | BIRCH RUN |
| State | MI |
| Zip Code | 48415 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609322486 | Birch Run Chiropractic Clinic Plc | Chiropractor | 7890 Main, Birch Run, MI 48415 | 2016-08-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457902140 | Linda Pabis | Technician | 5406 Canada Rd, Birch Run, MI 48415 | 2019-09-24 |
| 1821649948 | Hope Primary Care of Birch Run Pllc | Clinic/Center | 9143 Birh Run Rd, Ste 3, Birch Run, MI 48415 | 2019-09-20 |
| 1508368903 | John Paul Guidarelli | Physical Therapist | St. Mary's of Michigan, 9900 Birch Run Road, Birch Run, MI 48415 | 2018-03-02 |
| 1730609736 | Krista Lynn Emery | Registered Nurse | 13627 Block Rd, Birch Run, MI 48415 | 2017-06-21 |
| 1548485295 | Timothy D. Keinath | Pharmacist | 8501 Main St., Birch Run, MI 48415 | 2007-04-16 |
| 1790816585 | Donald Hobson | Dentist | 8155 Main Street, Birch Run, MI 48415 | 2007-03-07 |
| 1275631475 | Paul Charles Danek | Dentist | 9420 E Birch Run Rd, Birch Run, MI 48415 | 2006-09-20 |
| 1538266978 | Ascension St. Mary's Hospital | Family Medicine | 9900 East Birch Run Road, Birch Run, MI 48415 | 2006-09-20 |
| 1003848771 | Carroll Chiropractic Inc | Chiropractor | 11945 Conquest St, Birch Run, MI 48415 | 2006-07-06 |
| 1538133202 | April L Carroll | Chiropractor | 11945 Conquest Street, Birch Run, MI 48415 | 2006-02-17 |
| Find all providers in zip 48415 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366957144 | Candace C Gorges | Chiropractor | 7890 Main St, Birch Run, MI 48415-9232 | 2017-12-03 |
| 1003848771 | Carroll Chiropractic Inc | Chiropractor | 11945 Conquest St, Birch Run, MI 48415 | 2006-07-06 |
| 1538133202 | April L Carroll | Chiropractor | 11945 Conquest Street, Birch Run, MI 48415 | 2006-02-17 |
| 1609322486 | Birch Run Chiropractic Clinic Plc | Chiropractor | 7890 Main, Birch Run, MI 48415 | 2016-08-31 |
| 1538429931 | Carroll Chiropractic, Inc | Chiropractor | 11945 Conquest St, Birch Run, MI 48415-9294 | 2012-05-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860240 | Moriah K Severance | Chiropractor | 2449 W Kimmel Rd, Jackson, MI 49201-9783 | 2020-10-30 |
| 1760082465 | David Scott Severance | Chiropractor | 11720 Tompkins Rd, Rives Junction, MI 49277-9629 | 2020-10-30 |
| 1760082705 | Kelly Chiropractic Clinic, LLC | Chiropractor | 3179 12 Mile Rd, Berkley, MI 48072-1339 | 2020-10-29 |
| 1619584273 | Sydnee Laree Rutledge | Chiropractor | 3634 Mccain Rd Ste 7, Jackson, MI 49203-2576 | 2020-09-28 |
| 1790391860 | Ferras Dassouki | Chiropractor | 1126 Hunter Ct, Milford, MI 48381-3180 | 2020-09-23 |
| 1811503972 | Nicholas Heiserman | Chiropractor | 498 E Monroe St, Dundee, MI 48131-1321 | 2020-09-23 |
| 1114532835 | Pro-active Chiropractic Wellness of Grand Rapids | Chiropractor | 4270 Plainfield Ave Ne # E, Grand Rapids, MI 49525-1603 | 2020-09-10 |
| 1215540463 | Lake State Chiropractic Pllc | Chiropractor | 2155 84th St Sw Ste 4, Byron Center, MI 49315-8259 | 2020-08-27 |
| 1609488402 | Primrose Family Chiropractic and Wellness Center | Chiropractor | 25900 Greenfield Rd Suite 252, Oak Park, MI 48237-1297 | 2020-08-21 |
| 1780295063 | Wilhelm Family Chiropractic and Massage Pllc | Chiropractor | 23200 Pontiac Trl, South Lyon, MI 48178-1983 | 2020-08-11 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. KENNETH ROBERT TILLER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.