Individual provider Active NPI

Eric J Delamielleure, D.C.

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1528088531
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301007280 Issued in MI
Practice address
5060 Cascade Rd SE
Suite E
Grand Rapids, MI 49546-3808
Phone
(616) 940-4647
Fax
(616) 942-2497
NPI assigned
Jul 20, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301007280 MI Primary

Addresses

Primary practice location

5060 Cascade Rd SE
Suite E
Grand Rapids, MI 49546-3808

Mailing address

5060 Cascade Rd SE
Suite E
Grand Rapids, MI 49546-3808
Phone (616) 940-4647

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060127000701 MI Practitioner - Chiropractic 6901810217 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Chiropractic Unlimited, PLLC Chiropractor CurrentSince Feb 1, 2006 Accepting new patients

Locations

5060 Cascade Rd SE
Ste E
Grand Rapids, MI 49546
Phone (616) 940-4647

836 FRST HLS Ave
Grand Rapids, MI 49546
Phone (616) 940-4647

5131 East Paris Ave SE
Kentwood, MI 49512
Phone (616) 554-1299

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528088531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5060 CASCADE RD SE",
            "address_2": "SUITE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463808",
            "telephone_number": "616-940-4647",
            "fax_number": "616-942-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5060 CASCADE RD SE",
            "address_2": "SUITE E",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495463808",
            "telephone_number": "616-940-4647",
            "fax_number": "616-942-2497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELAMIELLEURE",
        "first_name": "ERIC",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jul 8, 2007; 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.