Tyler Gene Gunderson, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2301401220 Issued in MI

Practice address

258 James St Unit 10
Holland, MI 49424-1806

Phone

(616) 396-6635

NPI assigned

Jan 5, 2022

Last updated

Jan 5, 2022By the provider in NPPES

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, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeshore Family Chiropractic PLCGroup PAC ID 1759386790, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• Lakeshore Family Chiropractic, PLC

  • Clinic/Center
  • Holland, MI
  • NPI 1508978933
  Medicare reassignment Care Compare group NPD
• Big Rapids Chiropractic, PLC

  • Chiropractor
  • Big Rapids, MI
  • NPI 1760954697
  NPD (past)

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

{
    "created_epoch": "1641340800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641340800000",
    "number": "1902567514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13670 CARMELLA LN APT A",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494248480",
            "telephone_number": "810-841-3323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 JAMES ST UNIT 10",
            "city": "HOLLAND",
            "state": "MI",
            "postal_code": "494241806",
            "telephone_number": "616-396-6635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUNDERSON",
        "first_name": "TYLER",
        "middle_name": "GENE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-05",
        "last_updated": "2022-01-05",
        "certification_date": "2022-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "2301401220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Johanna Hillegonda Groot, PTA
• Alanna Gruppen
• Tonia Gruppen, A.T.C.
• Alice Guillory, MSW
• Patricia S Guisinger, DPM
• Eric Karl Gustafson, MD
• Mark Gustafson, PHARM.D.
• Leonela Guzman
• Lisa Paulukovich Ha, BEHAVIOR TECHNICIAN
• Sandi Lynn Haan, RDN,CEDS-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2022; 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.