Organization Active NPI

Hungerford Chiropractic & Wellness Center PC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1528314200
Registry record updated Nov 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009688 Issued in MI
Legal business name
HUNGERFORD CHIROPRACTIC & WELLNESS CENTER PC
Practice address
4172 Lake Michigan Dr NW
Grand Rapids, MI 49534-4527
Phone
(269) 377-9583
NPI assigned
Jul 31, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2012

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

Authorized official

Name
Dr. Daniel William Hungerford, D.C.NPI 1598067589
Title
Doctor of Chiropractic
Phone
(269) 377-9583

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2301009688 MI Primary

Addresses

Primary practice location

4172 Lake Michigan Dr NW
Grand Rapids, MI 49534-4527

Mailing address

4172 Lake Michigan Dr NW
Grand Rapids, MI 49534-4527
Phone (616) 419-4996

Other identifiers 1

IdentifierTypeStateIssuer
1598067589MedicaidMI

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130103000417 MI Part B Supplier - Clinic/Group Practice 7810140647 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Rapids, MI

National Provider Directory

National Provider Directory

Locations

4172 Lake Michigan Dr NW
Grand Rapids, MI 49534
Phone (616) 419-4996

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1343692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1353888000000",
    "number": "1528314200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4172 LAKE MICHIGAN DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495344527",
            "telephone_number": "616-419-4996",
            "fax_number": "616-419-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4172 LAKE MICHIGAN DR NW",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495344527",
            "telephone_number": "269-377-9583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNGERFORD CHIROPRACTIC & WELLNESS CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-31",
        "last_updated": "2012-11-26",
        "status": "A",
        "authorized_official_last_name": "HUNGERFORD",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "DOCTOR OF CHIROPRACTIC",
        "authorized_official_telephone_number": "269-377-9583",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009688",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1598067589",
            "state": "MI"
        }
    ],
    "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 Nov 26, 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.