Individual provider Active NPI

Marc Andrew Demeester, D.C.

  • Chiropractor
  • Grandville, MI
National Provider Identifier
1720331887
Registry record updated Feb 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
6367 Issued in CO
Practice address
209 Bliss Dr SW
Grandville, MI 49418-2108
Phone
(303) 601-3820
NPI assigned
Oct 25, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 6367 CO Primary
Thermography Chiropractor 111NT0100X 6367 CO

Addresses

Primary practice location

209 Bliss Dr SW
Grandville, MI 49418-2108

Mailing address

209 Bliss Dr SW
Grandville, MI 49418-2108
Phone (303) 601-3820

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160224001908 MI Practitioner - Chiropractic 4385949676 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Higher Health Chiropractic IncGroup PAC ID 0840428769, 5 clinicians

Practice addresses (Care Compare)

1027 Gezon Pkwy SW
Wyoming, MI 49509-9542
Phone (616) 301-8300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6367COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Higher Health Chiropractic Inc Chiropractor CurrentSince Jan 23, 2016 Accepting new patients

Locations

180 Baldwin St
Ste 101
Jenison, MI 49428
Phone (616) 574-2871

1027 Gezon Pkwy SW
Wyoming, MI 49509
Phone (616) 301-4961

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422835200000",
    "number": "1720331887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "209 BLISS DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182108",
            "telephone_number": "303-601-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "209 BLISS DR SW",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182108",
            "telephone_number": "303-601-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMEESTER",
        "first_name": "MARC",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-25",
        "last_updated": "2015-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "6367",
            "primary": true
        },
        {
            "code": "111NT0100X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Thermography",
            "state": "CO",
            "license": "6367",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2015; 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.