Kelli Anne Wilcox-Degraaf, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301009030 Issued in MI

Practice address

5900 Alpine Ave NW
Comstock Park, MI 49321-9717

Phone

(616) 784-5433

Fax

(616) 784-3577

NPI assigned

Aug 27, 2006

Last updated

Aug 15, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1156636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313366400000",
    "number": "1104934496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5900 ALPINE AVE NW",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493219717",
            "telephone_number": "616-784-5433",
            "fax_number": "616-784-3577"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5900 ALPINE AVE NW",
            "city": "COMSTOCK PARK",
            "state": "MI",
            "postal_code": "493219717",
            "telephone_number": "616-784-5433",
            "fax_number": "616-784-3577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILCOX-DEGRAAF",
        "first_name": "KELLI",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-27",
        "last_updated": "2011-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009030",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD OF MICHIGAN",
            "identifier": "0D11549",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Woodward

• Chiropractor in Comstock Park, MI
• Providers in Comstock Park, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.