Tyler Jeffrey Vanderwal, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301010630 Issued in MI

Practice address

649 Emmons St SE
Caledonia, MI 49316-8316

Phone

(616) 891-8153

Fax

(616) 891-8153

NPI assigned

Feb 21, 2018

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

Enrolled in MI

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Chiropractic Health Center of RockfordGroup PAC ID 5193780401, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Chiropractic Health Center of Rockford

  • Chiropractor
  • Rockford, MI
  • NPI 1710042999
  Medicare reassignment Care Compare group NPD
• Seif Chiropractic PC

  • Chiropractor
  • Caledonia, MI
  • NPI 1427192079
  Medicare reassignment NPD
• Integrated Physical Medicine PLLC

  • Family Medicine Physician
  • Rockford, MI
  • NPI 1790067015
  NPD (past)

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

{
    "created_epoch": "1519171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1519171200000",
    "number": "1669972188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2061 RIDGECREST RD SE APT 6",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495464373",
            "telephone_number": "616-350-7313"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "649 EMMONS ST SE",
            "city": "CALEDONIA",
            "state": "MI",
            "postal_code": "493168316",
            "telephone_number": "616-891-8153",
            "fax_number": "616-891-8153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDERWAL",
        "first_name": "TYLER",
        "middle_name": "JEFFREY",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-02-21",
        "last_updated": "2018-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin A Vander Heide, D.D.S.
• Mary Sue Vander Stel
• Vanderheide Counseling LLC
• Michelle Vanderheide, LMSW
• Joel Eric Vanderlugt, P.T. , D.P.T.
• Bradley Garrett Vanhoose, DDS, MS
• Mallory Vanregenmorter
• Nancy Jean Vantill, RPH
• Dennis Seth Vanwormer, D.O.
• Austin Vasquez

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.