Functional Chiropractic PLLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

04631 Issued in IA

Legal business name

FUNCTIONAL CHIROPRACTIC PLLC

Practice address

329 W Walnut St
Ogden, IA 50212-3048

Phone

(515) 232-9075

NPI assigned

Sep 26, 2011

Last updated

Sep 26, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard A Elbert, D.C.NPI 1285608620

Title

Owner

Phone

(515) 232-9075

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

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.

• Richard A Elbert, D.C.

  • Chiropractor
  • Ames, IA
  • NPI 1285608620
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316995200000",
    "number": "1013290030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "329 W WALNUT ST",
            "city": "OGDEN",
            "state": "IA",
            "postal_code": "502123048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 W WALNUT ST",
            "city": "OGDEN",
            "state": "IA",
            "postal_code": "502123048",
            "telephone_number": "515-232-9075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUNCTIONAL CHIROPRACTIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-09-26",
        "status": "A",
        "authorized_official_last_name": "ELBERT",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "515-232-9075",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "04631",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0155598",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1285608620",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicole Chisum, NP
• Briles Christenson, PA-C
• Helen Burk Clark, PT
• Katie Joanne Eatock, O.T.
• Brady Stuart France, D.D.S.
• Jeffrey R Gragg, DDS
• Kent W. Gragg, D.D.S.
• GRX Holdings, LLC
• GRX Holdings, LLC (Medicap Pharmacy)
• Haydee G Hernandez, D.O.

• Chiropractor in Ogden, IA
• Providers in Ogden, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.