Active NPI
Otto Albert Geiseman IV, D.C
- Chiropractor
- Plymouth, MI
National Provider Identifier
1033546197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301010368
- Practice address
- 595 Forest Ave
Ste 7B
Plymouth, MI 48170-1777 - Phone
- (734) 335-3635
- Fax
- (734) 468-0167
- NPI assigned
- Oct 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301010368 | MI | Primary |
Addresses
Primary practice location
595 Forest Ave
Ste 7B
Plymouth, MI 48170-1777
Mailing address
595 Forest Ave
Ste 7B
Plymouth, MI 48170-1777
Phone (734) 335-3635
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301010368 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1463702400000",
"number": "1033546197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "595 FOREST AVE",
"address_2": "STE 7B",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481701777",
"telephone_number": "734-335-3635",
"fax_number": "734-468-0167"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 FOREST AVE",
"address_2": "STE 7B",
"city": "PLYMOUTH",
"state": "MI",
"postal_code": "481701777",
"telephone_number": "734-335-3635",
"fax_number": "734-468-0167"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GEISEMAN",
"first_name": "OTTO",
"middle_name": "ALBERT",
"name_prefix": "Dr.",
"name_suffix": "IV",
"credential": "D.C",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-03",
"last_updated": "2016-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301010368",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Plymouth, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.