Individual provider Active NPI

Trent J Fugere, D.C.

  • Chiropractor
  • Clive, IA
National Provider Identifier
1033204532
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05949 Issued in IA
Practice address
2180 NW 156TH St
Suite 102
Clive, IA 50325
Phone
(515) 987-0299
Fax
(515) 987-5865
NPI assigned
Oct 3, 2006
Last updated
Jun 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05949 IA Primary

Addresses

Primary practice location

2180 NW 156TH St
Suite 102
Clive, IA 50325

Mailing address

2180 NW 156TH St
Suite 102
Clive, IA 50325
Phone (515) 987-0299

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511000716 IA Practitioner - Chiropractic 1153361852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

9500 University Ave
Suite 2106
West Des Moines, IA 50266-1870
Phone (515) 987-0299

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Waukee Chiropractic Center PC Chiropractor CurrentSince Feb 15, 2016 Accepting new patients

Locations

2180 NW 156th St
Ste 102
Clive, IA 50325
Phone (515) 987-0299

9500 University Ave
Ste 2106
West Des Moines, IA 50266
Phone (515) 987-0299

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214438400000",
    "number": "1033204532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2180 NW 156TH ST",
            "address_2": "SUITE 102",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "50325",
            "telephone_number": "515-987-0299",
            "fax_number": "515-987-5865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2180 NW 156TH ST",
            "address_2": "SUITE 102",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "50325",
            "telephone_number": "515-987-0299",
            "fax_number": "515-987-5865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUGERE",
        "first_name": "TRENT",
        "middle_name": "J",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2008-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05949",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2008; 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.