Elisha Blackmar Van Deusen IV, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC28866 Issued in CA

Practice address

17220 Newhope St
Suite 123
Fountain Valley, CA 92708-4272

Phone

(714) 556-6966

Fax

(714) 556-6967

NPI assigned

Aug 14, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Van Deusen Chiropractic IncGroup PAC ID 9032154869, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Van Deusen Chiropractic, Inc

  • Chiropractor
  • Costa Mesa, CA
  • NPI 1699830620
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1429228800000",
    "number": "1265445837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17220 NEWHOPE ST",
            "address_2": "SUITE 123",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084272",
            "telephone_number": "714-556-6966",
            "fax_number": "714-556-6967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17220 NEWHOPE ST",
            "address_2": "SUITE 123",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084272",
            "telephone_number": "714-556-6966",
            "fax_number": "714-556-6967"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DEUSEN",
        "first_name": "ELISHA",
        "middle_name": "BLACKMAR",
        "name_prefix": "Dr.",
        "name_suffix": "IV",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2015-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC28866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leonard Valentine, DC
• Michael J Valentine, DC
• Judith Valenzuela
• Valley View Comprehensive Care
• Kimberly Van Der Ham
• Van H Vu MD, Inc
• Van Huy Vu, MD, Inc.
• Merilee Marie Vance, RN, CNM
• Rebecca Vandevelde
• Silvina Vargas

• Chiropractor in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2015; 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.