Individual provider Active NPI

Adam Thomas Van Gessel, D.C.

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1720370851
Registry record updated May 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301009813 Issued in MI
Practice address
4612 Plainfield Ave NE
Grand Rapids, MI 49525-1229
Phone
(616) 363-7713
NPI assigned
May 9, 2011
Last updated
May 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301009813 MI Primary

Addresses

Primary practice location

4612 Plainfield Ave NE
Grand Rapids, MI 49525-1229

Mailing address

4612 Plainfield Ave NE
Grand Rapids, MI 49525-1229
Phone (616) 363-7713

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110719000244 MI Practitioner - Chiropractic 4284802208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Chiropractic Healthcare Center, PLLCGroup PAC ID 3173762077, 2 clinicians

Practice addresses (Care Compare)

3299 Clear Vista CT NE
Suite C
Grand Rapids, MI 49525-9326
Phone (616) 363-7713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2301009813MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Chiropractic Healthcare Center, PLLC Chiropractor CurrentSince Feb 25, 2013 Accepting new patients

Locations

3299 Clear Vista Ct NE
Ste C
Grand Rapids, MI 49525
Phone (616) 361-1200

4612 Plainfield Ave NE
Grand Rapids, MI 49525
Phone (616) 363-7713

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": "1304899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306108800000",
    "number": "1720370851",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4612 PLAINFIELD AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251229",
            "telephone_number": "616-363-7713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4612 PLAINFIELD AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495251229",
            "telephone_number": "616-363-7713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN GESSEL",
        "first_name": "ADAM",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-05-09",
        "last_updated": "2011-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301009813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2011; 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.