Individual provider Active NPI

Brenda O'Malley, DC

  • Chiropractor
  • Holland, MI
National Provider Identifier
1598760167
Registry record updated Jul 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301008919 Issued in MI
Practice address
399 E 32ND St
Ste 30
Holland, MI 49423-5518
Phone
(616) 392-5600
Fax
(616) 392-2055
NPI assigned
Jun 20, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301008919 MI Primary

Addresses

Primary practice location

399 E 32ND St
Ste 30
Holland, MI 49423-5518

Mailing address

399 E 32ND St
Ste 30
Holland, MI 49423-5518
Phone (616) 392-5600

Other identifiers 1

IdentifierTypeStateIssuer
0G011280OtherMIBCBSM

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050310000093 MI Practitioner - Chiropractic 0941254338 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2004
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

399 E 32ND St
Holland, MI 49423-5518
Phone (616) 392-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301008919MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
O'Malley Chiropractic LLC Chiropractor CurrentSince Feb 1, 2005 Accepting new patients

Locations

399 E 32nd St
Holland, MI 49423
Phone (616) 392-2222

399 E 32nd St
Ste 30
Holland, MI 49423
Phone (616) 392-5600

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": "1119225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532044800000",
    "number": "1598760167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "399 E 32ND ST",
            "address_2": "STE 30",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235518",
            "telephone_number": "616-392-5600",
            "fax_number": "616-392-2055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "399 E 32ND ST",
            "address_2": "STE 30",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494235518",
            "telephone_number": "616-392-5600",
            "fax_number": "616-392-2055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'MALLEY",
        "first_name": "BRENDA",
        "name_prefix": "Miss",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-20",
        "last_updated": "2018-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301008919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSM",
            "identifier": "0G011280",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Holland, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2018; 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.