Individual provider Active NPI

Jasmine Lena Hornberger, D.C.

  • Chiropractor
  • Grand Haven, MI
National Provider Identifier
1376841031
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009795 Issued in MI
Practice address
1428 Waverly Ave
Grand Haven, MI 49417-2392
Phone
(616) 846-3860
NPI assigned
Mar 4, 2011
Last updated
Jan 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009795 MI Primary

Addresses

Primary practice location

1428 Waverly Ave
Grand Haven, MI 49417-2392

Mailing address

1428 Waverly Ave
Grand Haven, MI 49417-2392
Phone (616) 846-3860

Other identifiers 1

IdentifierTypeStateIssuer
0C30350OtherMIBCBSM PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110408000199 MI Practitioner - Chiropractic 0840474201 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Inspired Health Chiropractic CurrentSince Apr 27, 2012 Accepting new patients
Inspired Health Chiropractic PC CurrentSince Apr 27, 2012 Accepting new patients

Locations

1428 Waverly Ave
Grand Haven, MI 49417
Phone (616) 846-3860

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1299196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1376841031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1428 WAVERLY AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172392",
            "telephone_number": "616-846-3860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1428 WAVERLY AVE",
            "city": "GRAND HAVEN",
            "state": "MI",
            "postal_code": "494172392",
            "telephone_number": "616-846-3860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HORNBERGER",
        "first_name": "JASMINE",
        "middle_name": "LENA",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-04",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009795",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM PIN",
            "identifier": "0C30350",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Haven, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.