Individual provider Active NPI

Justin Derek Casey, D.C.

  • Chiropractor
  • Marshall, MI
National Provider Identifier
1790124865
Registry record updated Oct 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2301010054 Issued in MI
Practice address
420 E Michigan Ave
Marshall, MI 49068-1667
Phone
(269) 781-6417
Fax
(269) 781-2522
NPI assigned
Jun 21, 2013
Last updated
Oct 8, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2301010054 MI Primary

Addresses

Primary practice location

420 E Michigan Ave
Marshall, MI 49068-1667

Mailing address

420 E Michigan Ave
Marshall, MI 49068-1667
Phone (269) 781-6417

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20131217001671 MI Practitioner - Chiropractic 1456588565 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

32 Van Buren St W
Battle Creek, MI 49017-3046
Phone (269) 966-2006

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wallace Chiropractic Center Chiropractor Current Accepting new patients

Organizations & group practices 3

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": "1371772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1381190400000",
    "number": "1790124865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 E MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681667",
            "telephone_number": "269-781-6417",
            "fax_number": "269-781-2522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 E MICHIGAN AVE",
            "city": "MARSHALL",
            "state": "MI",
            "postal_code": "490681667",
            "telephone_number": "269-781-6417",
            "fax_number": "269-781-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASEY",
        "first_name": "JUSTIN",
        "middle_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301010054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marshall, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2013; 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.