Individual provider Active NPI

Kaitlyn Sorenson, DC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1275235228
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301401409 Issued in MI
Practice address
5005 Plainfield Ave NE Ste 100
Grand Rapids, MI 49525-2087
Phone
(616) 279-3869
NPI assigned
Mar 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301401409 MI Primary

Addresses

Primary practice location

5005 Plainfield Ave NE Ste 100
Grand Rapids, MI 49525-2087

Mailing address

5005 Plainfield Ave NE Ste 100
Grand Rapids, MI 49525-2087
Phone (616) 279-3869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251212000394 MI Practitioner - Chiropractic 5799279147 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

612 Bayberry Pointe Dr NW
Apt H
Grand Rapids, MI 49534-4604

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301401409MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Kids Therapy Center LLC Chiropractor CurrentSince Jun 30, 2024 Accepting new patients
Wise Owl Wellness PLLC Chiropractor CurrentSince Oct 14, 2025 Accepting new patients
Full Potential Chiropractic, PC Chiropractor PastSince Mar 1, 2023 Accepting new patients

Locations

9809 Cherry Valley Ave SE
Ste D
Caledonia, MI 49316
Phone (269) 223-7786

5005 Plainfield Ave NE
Ste 100
Grand Rapids, MI 49525
Phone (616) 279-3869

Organizations & group practices 3

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": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766966400000",
    "number": "1275235228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5005 PLAINFIELD AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252087",
            "telephone_number": "616-279-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5005 PLAINFIELD AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495252087",
            "telephone_number": "616-279-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORENSON",
        "first_name": "KAITLYN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-21",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401409",
            "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 Dec 29, 2025; 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.