David Mark Van Drisse, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

3145-012 Issued in WI

Practice address

502 George St
De Pere, WI 54115-2714

Phone

(920) 337-0103

NPI assigned

Sep 22, 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 WI

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Van Drisse Chiropractic Center LLCGroup PAC ID 8921017682, 3 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.

• Van Drisse Chiropractic Center LLC

  • Chiropractor
  • De Pere, WI
  • NPI 1194913434
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1358812800000",
    "number": "1386743797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 GEORGE ST",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541152714",
            "telephone_number": "920-337-0103"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 GEORGE ST",
            "city": "DE PERE",
            "state": "WI",
            "postal_code": "541152714",
            "telephone_number": "920-337-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DRISSE",
        "first_name": "DAVID",
        "middle_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-22",
        "last_updated": "2013-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "3145-012",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Urology Associates of Green Bay, S.C.
• Kenneth G Utech, MSW
• Abhilash R Vaishnav, MD
• Van Drisse Chiropractic Center LLC
• Alec David Van Drisse, DC
• Ashley R Van Dyn Hoven, COTA
• Stacey Lyn Van Grinsven, MS, CFY-SLP
• Chelsea Van Hefty, R.N.
• Kari Ellen Van Lanen, OTR
• Aspen Marie Van Straten, APNP

• Chiropractor in De Pere, WI
• Providers in De Pere, WI by specialty
• Chiropractor in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2013; 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.