Individual provider Active NPI

Matthew Charles Ziesemer, D.C.

  • Chiropractor
  • Zeeland, MI
National Provider Identifier
1073780847
Registry record updated Dec 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009415 Issued in MI
Practice address
9479 Riley St Ste 245
Zeeland, MI 49464-8750
Phone
(616) 239-1105
NPI assigned
May 12, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 7, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009415 MI Primary

Addresses

Primary practice location

9479 Riley St Ste 245
Zeeland, MI 49464-8750

Mailing address

9479 Riley St Ste 245
Zeeland, MI 49464-8750
Phone (616) 239-1105

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081031000245 MI Practitioner - Chiropractic 9032278346 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009415MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Roots Chiropractic LLC Chiropractor CurrentSince May 1, 2015 Accepting new patients
Ak Chiropractic Research Center PLLC Chiropractor Past Accepting new patients

Locations

84 E Lakewood Blvd
Holland, MI 49424
Phone (616) 392-2166

388 Garden Ave
Ste 140
Holland, MI 49424
Phone (616) 294-1073

9479 Riley St
Ste 245
Zeeland, MI 49464
Phone (217) 549-6382

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1210550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670371200000",
    "number": "1073780847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9479 RILEY ST STE 245",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494648750",
            "telephone_number": "616-239-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9479 RILEY ST STE 245",
            "city": "ZEELAND",
            "state": "MI",
            "postal_code": "494648750",
            "telephone_number": "616-239-1105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZIESEMER",
        "first_name": "MATTHEW",
        "middle_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-12",
        "last_updated": "2022-12-07",
        "certification_date": "2022-12-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009415",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zeeland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.