Organization Active NPI

Back Home Chiropractic, LLC

  • Chiropractor
  • Monticello, IA
National Provider Identifier
1013266188
Registry record updated Jan 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BACK HOME CHIROPRACTIC, LLC
Practice address
818 W 1St St Ste 101
Monticello, IA 52310-1307
Phone
(319) 465-4663
Fax
(319) 465-3362
NPI assigned
Sep 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 14, 2016

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

Authorized official

Name
Dr. Nancy J Jesenovec-Stumma, DCNPI 1801144175
Title
Chiropractor/Owner
Phone
(319) 465-4663

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

818 W 1St St Ste 101
Monticello, IA 52310-1307

Mailing address

818 W 1St St Ste 101
Monticello, IA 52310-1307
Phone (319) 465-4663

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130107000210 IA Part B Supplier - Clinic/Group Practice 8628221314 Receives reassigned benefits from 1 practitioner
Practice locations: Monticello, IA

National Provider Directory

National Provider Directory

Locations

818 W 1st St
Ste 101
Monticello, IA 52310
Phone (319) 465-4663

218 W 1st St
Ste C
Monticello, IA 52310
Phone (319) 465-4663

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1346803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1452729600000",
    "number": "1013266188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 W 1ST ST STE 101",
            "city": "MONTICELLO",
            "state": "IA",
            "postal_code": "523101307",
            "telephone_number": "319-465-4663",
            "fax_number": "319-465-3362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 W 1ST ST STE 101",
            "city": "MONTICELLO",
            "state": "IA",
            "postal_code": "523101307",
            "telephone_number": "319-465-4663",
            "fax_number": "319-465-3362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK HOME CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-05",
        "last_updated": "2016-01-14",
        "status": "A",
        "authorized_official_last_name": "JESENOVEC-STUMMA",
        "authorized_official_first_name": "NANCY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "319-465-4663",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monticello, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2016; 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.