CLYDE PARK CHIROPRACTIC, P.C.
NPI 1811140858
Chiropractor in Wyoming, MI
About Clyde Park Chiropractic, P.c. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CLYDE PARK CHIROPRACTIC, P.C. (NPI 1811140858) is a healthcare organization registered as a chiropractor in Wyoming, Michigan and active in the NPI registry since November 2008. The organization lists Mary E. Gladish, President, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Clyde Park Chiropractic, P.c. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by November 30, 2026
Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Clyde Park Chiropractic, P.C., 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 Clyde Park Chiropractic, P.C.'s NPI number?
The NPI number for Clyde Park Chiropractic, P.C. is 1811140858. It was assigned to this organization in the NPPES registry on November 3, 2008.
Where is Clyde Park Chiropractic, P.C. located?
Clyde Park Chiropractic, P.C. is located at 4315 Clyde Park Ave SW, Wyoming, MI 49509. The listed phone number is (616) 532-4500.
What is Clyde Park Chiropractic, P.C.'s specialty?
The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.
Is Clyde Park Chiropractic, P.C. enrolled in Medicare?
Yes. Clyde Park Chiropractic, P.C. is registered in the Medicare PECOS enrollment system.
When is Clyde Park Chiropractic, P.C.'s Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Michigan, Clinic/Group Practice) is due for revalidation by November 30, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.
How many clinicians bill Medicare through Clyde Park Chiropractic, P.C.?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Chiropractic) reassigns their Medicare billing to Clyde Park Chiropractic, P.C.. 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 Clyde Park Chiropractic, P.C. was last updated on November 3, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.
# Clyde Park Chiropractic, P.c. · NPI 1811140858
Chiropractor organization in Wyoming, Michigan. Organization record, active in the CMS NPPES registry since November 3, 2008.
## Identity
- **NPI:** 1811140858 (Entity type: Organization)
- **Enumerated:** November 3, 2008
- **Primary specialty:** Chiropractor · taxonomy 111N00000X
- **Organization subpart:** No
- **Authorized official:** Mary Gladish, PRESIDENT
## Practice location
- **Address:** 4315 CLYDE PARK AVE SW, Wyoming, MI 49509-4101
- **Phone:** (616) 532-4500 · **Fax:** (616) 532-7344
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** November 30, 2026 (Non-DME Part B, Michigan, Clinic/Group Practice) · CMS Revalidation Due Date List, October 2026 release
- **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:** November 3, 2008
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Source: [NPI Profile](https://npiprofile.com/npi/1811140858) · Data from the CMS NPPES public registry.