Individual provider Active NPI

Alexander B Van Wyk, D.C.

  • Chiropractor
  • Des Moines, IA
National Provider Identifier
1851485825
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05150 Issued in IA
Practice address
2915 Hubbell Ave
Des Moines, IA 50317-3716
Phone
(515) 266-0214
Fax
(515) 263-9183
NPI assigned
Oct 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05150 IA Primary

Addresses

Primary practice location

2915 Hubbell Ave
Des Moines, IA 50317-3716

Mailing address

2915 Hubbell Ave
Des Moines, IA 50317-3716

Other identifiers 2

IdentifierTypeStateIssuer
237516OtherIAMIDLANDS CHOICE
00297OtherIAWELLMARK BCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100416000632 IA Practitioner - Chiropractic 1052448420 Practice locations: Des Moines, IA

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": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851485825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2915 HUBBELL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503173716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2915 HUBBELL AVE",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503173716",
            "telephone_number": "515-266-0214",
            "fax_number": "515-263-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN WYK",
        "first_name": "ALEXANDER",
        "middle_name": "B",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05150",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MIDLANDS CHOICE",
            "identifier": "237516",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS",
            "identifier": "00297",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

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.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.