Individual provider Active NPI

Ian D. McLean, D.C. DACBR

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1013926484
Registry record updated Mar 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
04972 Issued in IA
Practice address
1000 Brady St
Davenport, IA 52803-5214
Phone
(563) 884-5423
NPI assigned
Aug 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 04972 IA Primary

Addresses

Primary practice location

1000 Brady St
Davenport, IA 52803-5214

Mailing address

1000 Brady St
Davenport, IA 52803-5214
Phone (563) 884-5423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20091016000179 IA Practitioner - Chiropractic 4981741394 Reassigns benefits to 1 organization
I20110323000766 IL Practitioner - Chiropractic 4981741394 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04972IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Palmer College Foundation Chiropractor CurrentSince Aug 9, 2009 Accepting new patients
Palmer College Foundation Chiropractor CurrentSince Dec 1, 2010 Accepting new patients

Locations

1000 Brady St
Davenport, IA 52803
Phone (563) 884-5800

2001 52nd Ave
Ste 1
Moline, IL 61265
Phone (309) 736-9317

Networks

  • devoted network organization-1baeae7e-6b6f-49f9-a562-1b2d2e55c806

Organizations & group practices 2

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": "1154736000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395100800000",
    "number": "1013926484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 BRADY ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035214",
            "telephone_number": "563-884-5423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 BRADY ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528035214",
            "telephone_number": "563-884-5423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCLEAN",
        "first_name": "IAN",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.C. DACBR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-05",
        "last_updated": "2014-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "04972",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2014; 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.