Active NPI
Gerard P Poortinga, D.C.
- Chiropractor
- Yellow Springs, OH
National Provider Identifier
1609990852
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 764
- Practice address
- 525 Dayton St
Yellow Springs, OH 45387-1709 - Phone
- (937) 767-1115
- Fax
- (937) 767-9997
- NPI assigned
- Mar 16, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 764 | OH | Primary |
Addresses
Primary practice location
525 Dayton St
Yellow Springs, OH 45387-1709
Mailing address
525 Dayton St
Yellow Springs, OH 45387-1709
Phone (937) 767-1115
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0450211 | Medicaid | OH |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174003200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1609990852",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "525 DAYTON ST",
"city": "YELLOW SPRINGS",
"state": "OH",
"postal_code": "453871709",
"telephone_number": "937-767-1115",
"fax_number": "937-767-9997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 DAYTON ST",
"city": "YELLOW SPRINGS",
"state": "OH",
"postal_code": "453871709",
"telephone_number": "937-767-1115",
"fax_number": "937-767-9997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POORTINGA",
"first_name": "GERARD",
"middle_name": "P",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "OH",
"license": "764",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0450211",
"state": "OH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Yellow Springs, OH
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.