Organization Active NPI

Crow Valley Chiropractic, P.C.

  • Chiropractor
  • Bettendorf, IA
National Provider Identifier
1023153533
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AO5528 Issued in IA
Legal business name
CROW VALLEY CHIROPRACTIC, P.C.
Practice address
2496 53Rd Ave
Bettendorf, IA 52722-6208
Phone
(563) 332-2944
Fax
(563) 332-2949
NPI assigned
Feb 21, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Michelle Marie Hahn
Title
Office Manager
Phone
(563) 332-2944

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X AO5528 IA Primary

Addresses

Primary practice location

2496 53Rd Ave
Bettendorf, IA 52722-6208

Mailing address

2496 53Rd Ave
Bettendorf, IA 52722-6208
Phone (563) 332-2944

Other identifiers 1

IdentifierTypeStateIssuer
AO5528OtherIALICENCE NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100504000024 IA Part B Supplier - Clinic/Group Practice 5991833477 Receives reassigned benefits from 1 practitioner
Practice locations: Bettendorf, IA

National Provider Directory

National Provider Directory

Locations

2496 53rd Ave
Bettendorf, IA 52722
Phone (563) 332-2944

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": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1023153533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2496 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527226208",
            "telephone_number": "563-332-2944",
            "fax_number": "563-332-2949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2496 53RD AVE",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527226208",
            "telephone_number": "563-332-2944",
            "fax_number": "563-332-2949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CROW VALLEY CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAHN",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "563-332-2944",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "AO5528",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENCE NUMBER",
            "identifier": "AO5528",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.