Active NPI
Lisa Marie Vermeulen, D.C.
- Chiropractor
- Grand Rapids, MI
National Provider Identifier
1487701108
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 2301009195
- Practice address
- 4535 3 Mile Rd NE
Grand Rapids, MI 49525-9331 - Phone
- (616) 551-5433
- Fax
- (616) 301-2630
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 2301009195 | MI | Primary |
Addresses
Primary practice location
4535 3 Mile Rd NE
Grand Rapids, MI 49525-9331
Mailing address
4535 3 Mile Rd NE
Grand Rapids, MI 49525-9331
Phone (616) 551-5433
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11668114 | Other | MI | CAQH PROVIDER ID |
Other names 1
- Lisa Marie Smith
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2301009195 | MI | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1487701108",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4535 3 MILE RD NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259331",
"telephone_number": "616-551-5433",
"fax_number": "616-301-2630"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4535 3 MILE RD NE",
"city": "GRAND RAPIDS",
"state": "MI",
"postal_code": "495259331",
"telephone_number": "616-551-5433",
"fax_number": "616-301-2630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VERMEULEN",
"first_name": "LISA",
"middle_name": "MARIE",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "MI",
"license": "2301009195",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAQH PROVIDER ID",
"identifier": "11668114",
"state": "MI"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "SMITH",
"middle_name": "MARIE",
"credential": "D.C.",
"code": "1",
"type": "Former Name"
}
]
}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 Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.