Active NPI
Brian Robert Marhofer, D.C.
- Chiropractor
- Grand Rapids, MI
National Provider Identifier
1194015065
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301009806
- Practice address
- 400 68TH St SW
Grand Rapids, MI 49548-7120 - Phone
- (616) 281-2500
- Fax
- (616) 281-2502
- NPI assigned
- Apr 13, 2011
- 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 | 2301009806 | MI | Primary |
Addresses
Primary practice location
400 68TH St SW
Grand Rapids, MI 49548-7120
Mailing address
400 68TH St SW
Grand Rapids, MI 49548-7120
Phone (616) 281-2500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
108 Northland Plaza
Gaston Family Chiropractic
Kalkaska, MI 49646-7408
Phone (231) 258-9874
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301009806 | MI | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gaston Family Chiropractic LLC | Chiropractor | Current | Accepting new patients |
Locations
108 Northland Plaza Rd
Kalkaska, MI 49646
Phone (231) 258-9874
13919 S West Bay Shore Dr
Ste G01
Traverse City, MI 49684
Phone (231) 929-7450
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.
-
- Chiropractor
- Traverse City, MI
- NPI 1912028200
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1302652800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1302652800000",
"number": "1194015065",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "400 68TH ST SW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495487120",
"telephone_number": "616-281-2500",
"fax_number": "616-281-2502"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 68TH ST SW",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495487120",
"telephone_number": "616-281-2500",
"fax_number": "616-281-2502"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MARHOFER",
"first_name": "BRIAN",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-04-13",
"last_updated": "2011-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301009806",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Grand Rapids, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 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.