Individual provider Active NPI

Ryan L Sorrell, DC

  • Chiropractor
  • Grand Rapids, MI
National Provider Identifier
1912096819
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
RS008936 Issued in MI
Practice address
6208 Kalamazoo Ave SE Ste C
Grand Rapids, MI 49508-7022
Phone
(616) 554-0077
Fax
(616) 554-0055
NPI assigned
Oct 11, 2006
Sex
Male
Sole proprietor
No

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 RS008936 MI Primary

Addresses

Primary practice location

6208 Kalamazoo Ave SE Ste C
Grand Rapids, MI 49508-7022

Mailing address

6208 Kalamazoo Ave SE Ste C
Grand Rapids, MI 49508-7022
Phone (616) 554-0077

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050701000619 MI Practitioner - Chiropractic 6608812433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

6208 Kalamazoo Ave SE B
Grand Rapids, MI 49508-7022
Phone (616) 554-0077

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RS008936MIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
C & R Family Chiropractic Center Chiropractor CurrentSince Oct 3, 2006 Accepting new patients

Locations

6208 Kalamazoo Ave SE
Ste C
Grand Rapids, MI 49508
Phone (616) 554-0077

6208 Kalamazoo Ave SE
Ste B
Grand Rapids, MI 49508
Phone (616) 322-4984

6208 Kalamazoo Ave SE
Kentwood, MI 49508
Phone (616) 554-0077

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912096819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6208 KALAMAZOO AVE SE STE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087022",
            "telephone_number": "616-554-0077",
            "fax_number": "616-554-0055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6208 KALAMAZOO AVE SE STE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495087022",
            "telephone_number": "616-554-0077",
            "fax_number": "616-554-0055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SORRELL",
        "first_name": "RYAN",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MI",
            "license": "RS008936",
            "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 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.
  • 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.