Organization Active NPI

Jason J. Hesselberg DC PLLC

  • Chiropractor
  • Ypsilanti, MI
National Provider Identifier
1245459221
Registry record updated Aug 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008173 Issued in MI
Legal business name
JASON J. HESSELBERG DC PLLC
Practice address
4039 Carpenter Rd
Ypsilanti, MI 48197-9272
Phone
(734) 677-0111
Fax
(734) 677-0135
NPI assigned
Apr 25, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2012

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

Authorized official

Name
Dr. Jason Joseph Hesselberg, D.C.NPI 1376690701
Title
Owner
Phone
(734) 677-0111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 2301008173 MI Primary

Addresses

Primary practice location

4039 Carpenter Rd
Ypsilanti, MI 48197-9272

Mailing address

4039 Carpenter Rd
Ypsilanti, MI 48197-9272
Phone (734) 677-0111

Other identifiers 1

IdentifierTypeStateIssuer
950H114020OtherMIBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130208000008 MI Part B Supplier - Clinic/Group Practice 6800040338 Receives reassigned benefits from 3 practitioners
Practice locations: Ypsilanti, MI

National Provider Directory

National Provider Directory

Locations

2900 Packard Rd
Ste 2
Ypsilanti, MI 48197
Phone (734) 677-0111

4039 Carpenter Rd
Ypsilanti, MI 48197
Phone (734) 677-0111

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177459200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345680000000",
    "number": "1245459221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4039 CARPENTER RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481979272",
            "telephone_number": "734-677-0111",
            "fax_number": "734-677-0135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4039 CARPENTER RD",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481979272",
            "telephone_number": "734-677-0111",
            "fax_number": "734-677-0135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON J. HESSELBERG DC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-25",
        "last_updated": "2012-08-23",
        "status": "A",
        "authorized_official_last_name": "HESSELBERG",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "734-677-0111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008173",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950H114020",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ypsilanti, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.