Active NPI
Brennan Edward Kersten
- Chiropractor
- Caledonia, MI
National Provider Identifier
1154028884
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301401327
- Practice address
- 1833 Marketplace Dr SE
Caledonia, MI 49316-8506 - Phone
- (616) 522-5610
- NPI assigned
- Feb 13, 2023
- Sex
- Male
- Sole proprietor
- No
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 | 2301401327 | MI | Primary |
Addresses
Primary practice location
1833 Marketplace Dr SE
Caledonia, MI 49316-8506
Mailing address
1833 Marketplace Dr SE
Caledonia, MI 49316-8506
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260508001060 | MI | Practitioner - Chiropractic | 9830667781 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Life Chiropractic College, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
8170 Emmett Rd
Brockway, MI 48097-3019
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301401327 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 100 Chiro Staples Mi PLLC | Chiropractor | Current | Accepting new patients |
Locations
1833 Marketplace Dr SE
Caledonia, MI 49316
Phone (616) 522-5610
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.
-
- Chiropractor
- Caledonia, MI
- NPI 1114780236
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676246400000",
"number": "1154028884",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1833 MARKETPLACE DR SE",
"city": "CALEDONIA",
"state": "MI",
"postal_code": "493168506"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1833 MARKETPLACE DR SE",
"city": "CALEDONIA",
"state": "MI",
"postal_code": "493168506",
"telephone_number": "616-522-5610"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KERSTEN",
"first_name": "BRENNAN",
"middle_name": "EDWARD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-02-13",
"last_updated": "2023-02-13",
"certification_date": "2023-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301401327",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Caledonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2023; 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.