NPIMap

Organization Active NPI

Ebert Chiropractic Clinic PC

  • Chiropractor
  • Waterloo, IA
National Provider Identifier
1043410087
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
04380 Issued in IA
Legal business name
EBERT CHIROPRACTIC CLINIC PC
Practice address
1445 Ansborough Avenue
Waterloo, IA 50701-3430
Phone
(319) 232-9436
Fax
(319) 232-2342
NPI assigned
Jul 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Authorized official

Name
Dr. Robert E Ebert, DC
Title
Chiropractor Owner
Phone
(319) 232-9436

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 04380 IA Primary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X 06912 IA

Addresses

Primary practice location

1445 Ansborough Avenue
Waterloo, IA 50701-3430

Mailing address

1445 Ansborough Avenue
Waterloo, IA 50701-3430
Phone (319) 232-9436

National Provider Directory

National Provider Directory

Locations

1445 Ansborough Ave
Waterloo, IA 50701
Phone (319) 232-9436

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1043410087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1445 ANSBOROUGH AVENUE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013430",
            "telephone_number": "319-232-9436",
            "fax_number": "319-232-2342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1445 ANSBOROUGH AVENUE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507013430",
            "telephone_number": "319-232-9436",
            "fax_number": "319-232-2342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EBERT CHIROPRACTIC CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CHIROPRACTOR OWNER",
        "authorized_official_telephone_number": "319-232-9436",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "04380",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.