Individual provider Active NPI

Kayla Ranger-Dean, D.C.

  • Chiropractor
  • Mattawan, MI
National Provider Identifier
1154426609
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
KR005892 Issued in MI
Practice address
55475 N Main St
Mattawan, MI 49071-8304
Phone
(269) 668-4521
Fax
(269) 668-4522
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X KR005892 MI Primary

Addresses

Primary practice location

55475 N Main St
Mattawan, MI 49071-8304

Mailing address

55475 N Main St
Mattawan, MI 49071-8304
Phone (269) 668-4521

Other identifiers 4

IdentifierTypeStateIssuer
4051784OtherILBCBS OF IL
44-30154OtherMIIBA-UNITED HEALTH CARE
2892570MedicaidMI
950H05015OtherMIBCBS OF MI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061220000060 MI Practitioner - Chiropractic 8426057431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

55475 N Main St
Mattawan, MI 49071-8304
Phone (269) 668-4521

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KR005892MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mattawan Chiropractic Clinic, P.C. Chiropractor CurrentSince Dec 15, 2006 Accepting new patients

Locations

55475 N Main St
Mattawan, MI 49071
Phone (269) 668-4521

Organizations & group practices 1

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": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1154426609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55475 N MAIN ST",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490718304",
            "telephone_number": "269-668-4521",
            "fax_number": "269-668-4522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55475 N MAIN ST",
            "city": "MATTAWAN",
            "state": "MI",
            "postal_code": "490718304",
            "telephone_number": "269-668-4521",
            "fax_number": "269-668-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANGER-DEAN",
        "first_name": "KAYLA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "KR005892",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL",
            "identifier": "4051784",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IBA-UNITED HEALTH CARE",
            "identifier": "44-30154",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2892570",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF MI",
            "identifier": "950H05015",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattawan, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.