Benjamin David Gillis, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301008777 Issued in MI

Practice address

5675 Burlingame Ave.
Suite a
Wyoming, MI 49509-9702

Phone

(616) 538-2200

Fax

(616) 301-0419

NPI assigned

Apr 18, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Gillis Family Chiropractic IncGroup PAC ID 8729262779, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Gillis Family Chiropractic Inc.

  • Chiropractor
  • Wyoming, MI
  • NPI 1023312774
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1356567358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5675 BURLINGAME AVE.",
            "address_2": "SUITE A",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099702",
            "telephone_number": "616-538-2200",
            "fax_number": "616-301-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5675 BURLINGAME AVE.",
            "address_2": "SUITE A",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495099702",
            "telephone_number": "616-538-2200",
            "fax_number": "616-301-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILLIS",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008777",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "950D113070",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "ON84880",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Gilchrist
• Tiffany June Gill, RN
• Jenna Gillespie
• Nancy Gillhespy, LPN
• Gillis Family Chiropractic Inc.
• Izabella Marie Gingerich
• Mary E Gladish, D.C.
• Julie Oljeto Glass, MA, LPC, LMFT
• Victoria Anne Glass
• Emalee Godard

• Chiropractor in Wyoming, MI
• Providers in Wyoming, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.