GREAT LAKES SPORTS & SPINE LLC
NPI 1710768494
Chiropractor in Willoughby, OH
About Great Lakes Sports & Spine Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
GREAT LAKES SPORTS & SPINE LLC (NPI 1710768494) is a healthcare organization registered as a chiropractor in Willoughby, Ohio and active in the NPI registry since October 2023. The organization lists Matthew Paul Martin, Owner/chiropractic Physician, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Great Lakes Sports & Spine Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Great Lakes Sports & Spine LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Great Lakes Sports & Spine LLC's NPI number?
The NPI number for Great Lakes Sports & Spine LLC is 1710768494. It was assigned to this organization in the NPPES registry on October 10, 2023.
Where is Great Lakes Sports & Spine LLC located?
Great Lakes Sports & Spine LLC is located at 34940 Ridge Rd Ste B, Willoughby, OH 44094. The listed phone number is (440) 527-8030.
What is Great Lakes Sports & Spine LLC's specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Great Lakes Sports & Spine LLC enrolled in Medicare?
Yes. Great Lakes Sports & Spine LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Great Lakes Sports & Spine LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Great Lakes Sports & Spine LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Great Lakes Sports & Spine LLC was last updated on October 10, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Great Lakes Sports & Spine Llc · NPI 1710768494
Chiropractor organization in Willoughby, Ohio. Organization record, active in the CMS NPPES registry since October 10, 2023.
## Identity
- **NPI:** 1710768494 (Entity type: Organization)
- **Enumerated:** October 10, 2023
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Matthew Martin, OWNER/CHIROPRACTIC PHYSICIAN
## Practice location
- **Address:** 34940 RIDGE RD STE B, Willoughby, OH 44094-4197
- **Phone:** (440) 527-8030
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Chiropractic) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 10, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1710768494) · Data from the CMS NPPES public registry.