Individual provider Active NPI

Brian Robert Marhofer, D.C.

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1194015065
Registry record updated Apr 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009806 Issued in MI
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

Updated by the provider on Apr 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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

Enrollment IDStateProvider typePAC IDDetails
I20110623000594 MI Practitioner - Chiropractic 7911185814 Reassigns benefits to 1 organization

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
Gaston Family Chiropractic LLCGroup PAC ID 4284711383, 2 clinicians

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

LicenseStateTypeSpecialty
2301009806MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gaston Family Chiropractic LLC Chiropractor CurrentSince Dec 1, 2023 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.

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.

Verify at the official NPI Registry.