Individual provider Active NPI

David P. Van Dyke, D.C.

  • Chiropractor
  • San Luis Obispo, CA
National Provider Identifier
1447387121
Registry record updated Jul 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC18264 Issued in CA
Practice address
1150 Grove St
San Luis Obispo, CA 93401-2914
Phone
(805) 541-2727
Fax
(805) 541-2729
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 15, 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 DC18264 CA Primary

Addresses

Primary practice location

1150 Grove St
San Luis Obispo, CA 93401-2914

Mailing address

1150 Grove Street
San Luis Obispo, CA 93401-2914
Phone (805) 514-2727

Other names 1

  • David P. Van Dyke Professional name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110502000069 CA Practitioner - Chiropractic 7416132774 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1150 Grove St
San Luis Obispo, CA 93401-2914
Phone (805) 541-2727

1241 Knollwood Dr
Suite 201B
Cambria, CA 93428-3337
Phone (805) 927-8631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DC18264CAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
David Van Dyke Chiropractic Inc Chiropractor CurrentSince Oct 13, 2010 Accepting new patients

Locations

1241 Knollwood Dr
Cambria, CA 93428
Phone (805) 927-8631

1150 Grove St
Sn Luis Obisp, CA 93401
Phone (805) 541-2727

Organizations & group practices 1

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": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752537600000",
    "number": "1447387121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 GROVE STREET",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012914",
            "telephone_number": "805-514-2727",
            "fax_number": "805-541-2729"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 GROVE ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012914",
            "telephone_number": "805-541-2727",
            "fax_number": "805-541-2729"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN DYKE",
        "first_name": "DAVID",
        "middle_name": "P.",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2025-07-15",
        "certification_date": "2025-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC18264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DAVID",
            "last_name": "VAN DYKE",
            "middle_name": "P.",
            "credential": "D. C.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in San Luis Obispo, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.