Tyler Gress, DC

Key facts

NPI

1154893717

Entity type

Individual (NPI type 1)

Primary specialty

Chiropractor 111N00000X

License

08003084A (IN)

Practice address

1928 45TH St
Munster, IN 46321-3917

Phone

(219) 476-7246

NPI assigned

Dec 20, 2018

Sex

Male

Sole proprietor

No

Organizations & group practices 5

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.

• Kauffman Chiropractic Chiropractor · Crown Point, IN · NPI 1114149366
  Medicare reassignment NPD CHIROPRACTOR · IN
• West 84TH Drive Chiropractic PC Chiropractor · Merrillville, IN · NPI 1477118818
  Medicare reassignment NPD CHIROPRACTOR · IN
• Premise Health of Illinois Medical PC Primary Care Clinic/Center · Mount Vernon, IL · NPI 1427366921
  Medicare reassignment NPD IL
• Kauffman Chiropractic Chiropractor · Merrillville, IN · NPI 1538381793
  NPD CHIROPRACTOR
• Premise Health of Illinois Medical PC Multi-Specialty Clinic/Center · Utica, IL · NPI 1295518868
  NPD

Medicare participation

Medicare fee-for-service enrollment

Enrolled (2 enrollments) in IN, IL

Medicare enrollment records

National Provider Directory

Medicare enrollment (NPD)

Yes

State licenses

Practice roles

Locations

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 13, 2019.

{
    "created_epoch": "1545264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1154893717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 LEGACY PLZ W",
            "city": "LA PORTE",
            "state": "IN",
            "postal_code": "463505285",
            "telephone_number": "219-476-7246",
            "fax_number": "219-476-1713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 45TH ST",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463213917",
            "telephone_number": "219-476-7246"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "204 Legacy Plz W",
            "address_purpose": "LOCATION",
            "city": "LA Porte",
            "state": "IN",
            "postal_code": "463505285",
            "country_code": "US",
            "telephone_number": "219-476-7246",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "855 Maple Ave",
            "address_purpose": "LOCATION",
            "city": "Homewood",
            "state": "IL",
            "postal_code": "604302031",
            "country_code": "US",
            "telephone_number": "708-305-0034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GRESS",
        "first_name": "TYLER",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-12-20",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013292",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08003084A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Munster, IN · Chiropractor in Indiana