Ryan Koolen, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301007736 Issued in MI

Practice address

9751 E Grand River Ave
Portland, MI 48875-9774

Phone

(517) 647-5770

Fax

(517) 647-5773

NPI assigned

Apr 10, 2006

Last updated

Sep 7, 2012By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Craft Chiropractic Center PC

  • Chiropractor
  • Charlotte, MI
  • NPI 1700849379
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1588627657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9751 E GRAND RIVER AVE",
            "address_2": "PO BOX 367",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "488759774",
            "telephone_number": "517-647-5770",
            "fax_number": "517-647-5773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9751 E GRAND RIVER AVE",
            "city": "PORTLAND",
            "state": "MI",
            "postal_code": "488759774",
            "telephone_number": "517-647-5770",
            "fax_number": "517-647-5773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOOLEN",
        "first_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301007736",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura S Johnson, CCC-SLP
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• KC Assisted Living Corporation
• Christina Knoop, NP
• Krystal Kempf Eye Care PLLC
• Terri Leann Lay
• Little Steps Therapy LLC
• Nancyann Pierce Lufkin, MSW
• Michael John Mauren, D.D.S.

• Chiropractor in Portland, MI
• Providers in Portland, MI by specialty
• Chiropractor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.