Organization Active NPI

De Jong Chiropractic

  • Chiropractor
  • Orange City, IA
National Provider Identifier
1013277870
Registry record updated May 25, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06472 Issued in IA
Legal business name
DE JONG CHIROPRACTIC
Practice address
110 Central Ave SW
Orange City, IA 51041-1740
Phone
(712) 737-9100
Fax
(712) 737-9101
NPI assigned
May 25, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 25, 2012

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

Authorized official

Name
Daron De Jong, D.C.NPI 1902866957
Title
Owner
Phone
(712) 737-9100

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 06472 IA Primary

Addresses

Primary practice location

110 Central Ave SW
Orange City, IA 51041-1740

Mailing address

110 Central Ave SW
Orange City, IA 51041-1740
Phone (712) 737-9100

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120606000388 IA Part B Supplier - Clinic/Group Practice 1658535521 Receives reassigned benefits from 1 practitioner
Practice locations: Orange City, IA

National Provider Directory

National Provider Directory

Locations

110 Central Ave SW
Orange City, IA 51041
Phone (712) 737-9100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1337904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337904000000",
    "number": "1013277870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CENTRAL AVE SW",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411740",
            "telephone_number": "712-737-9100",
            "fax_number": "712-737-9101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CENTRAL AVE SW",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411740",
            "telephone_number": "712-737-9100",
            "fax_number": "712-737-9101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DE JONG CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-25",
        "last_updated": "2012-05-25",
        "status": "A",
        "authorized_official_last_name": "DE JONG",
        "authorized_official_first_name": "DARON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-737-9100",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06472",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2012; 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.