Individual provider Active NPI

Jack Loy, DC

  • Chiropractor
  • Wyoming, MI
National Provider Identifier
1548050974
Registry record updated May 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301401613 Issued in MI
Practice address
2855 Byron Center Ave SW
Wyoming, MI 49519-2415
Phone
(616) 532-2518
NPI assigned
May 8, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 8, 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 2301401613 MI Primary

Addresses

Primary practice location

2855 Byron Center Ave SW
Wyoming, MI 49519-2415

Mailing address

2855 Byron Center Ave SW
Wyoming, MI 49519-2415
Phone (573) 239-6088

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250614000068 MI Practitioner - Chiropractic 6406367754 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kooistra Chiropractic Clinic PLLCGroup PAC ID 0042472672, 4 clinicians

Practice addresses (Care Compare)

2855 Byron Ctr Ave SW
Wyoming, MI 49519-2415
Phone (616) 532-2518

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301401613MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kooistra Chiropractic Clinic PLLC Chiropractor CurrentSince May 21, 2025 Accepting new patients
Michigan Pain Consultants PC PastSince May 11, 2025 Accepting new patients

Locations

2855 Byron Center Ave SW
Wyoming, MI 49519
Phone (616) 532-2518

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EJDADD

Organizations & group practices 2

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": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746662400000",
    "number": "1548050974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2855 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495192415",
            "telephone_number": "573-239-6088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2855 BYRON CENTER AVE SW",
            "city": "WYOMING",
            "state": "MI",
            "postal_code": "495192415",
            "telephone_number": "616-532-2518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOY",
        "first_name": "JACK",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-05-08",
        "last_updated": "2025-05-08",
        "certification_date": "2025-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyoming, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.