Individual provider Active NPI

Kasey George Herzberg, D.C.

  • Chiropractor
  • Clarinda, IA
National Provider Identifier
1023028271
Registry record updated Dec 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06456 Issued in IA
Practice address
112 N 16TH St
Suite a
Clarinda, IA 51632-1601
Phone
(712) 542-1404
Fax
(712) 542-2815
NPI assigned
Aug 9, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 06456 IA Primary

Addresses

Primary practice location

112 N 16TH St
Suite a
Clarinda, IA 51632-1601

Mailing address

112 N 16TH St
Suite a
Clarinda, IA 51632-1601
Phone (712) 542-1404

Other identifiers 1

IdentifierTypeStateIssuer
0298257MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120220000062 IA Practitioner - Chiropractic 0042202624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

112 N 16TH St
Suite a
Clarinda, IA 51632-1601
Phone (712) 542-1404

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06456IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Herzberg Chiropractic, P.C. Chiropractor CurrentSince Jan 1, 2003 Accepting new patients

Locations

112A N 16th St
Clarinda, IA 51632
Phone (712) 542-8046

112 N 16th St
#A
Clarinda, IA 51632
Phone (712) 542-1404

Networks

  • CO HMO D-SNP
  • IA HMO C-SNP
  • devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
  • devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
  • IA HMO
  • CO HMO

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": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324339200000",
    "number": "1023028271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N 16TH ST",
            "address_2": "SUITE A",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321601",
            "telephone_number": "712-542-1404",
            "fax_number": "712-542-2815"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N 16TH ST",
            "address_2": "SUITE A",
            "city": "CLARINDA",
            "state": "IA",
            "postal_code": "516321601",
            "telephone_number": "712-542-1404",
            "fax_number": "712-542-2815"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERZBERG",
        "first_name": "KASEY",
        "middle_name": "GEORGE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2011-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0298257",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarinda, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2011; 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.