Keith Robert Chvatal, DC – Chiropractor in Wahoo, NE

Key facts

NPI: 1043722309
Entity type: Individual (NPI type 1)
Primary specialty: Chiropractor 111N00000X
License: 1955 (NE)
Practice address: 1320 E 31St St
Wahoo, NE 68066-5581
Phone: (024) 277-7180
Fax: (402) 277-7182
NPI assigned: Oct 26, 2017
Sex: Male
Sole proprietor: Yes

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.

Saunders County Chiropractic & Acupuncture, PC Chiropractor · Wahoo, NE · NPI 1417345281

Medicare reassignment Care Compare group NPD CHIROPRACTOR · NE

Medicare Care Compare profile

Specialty: Chiropractic
Education: Palmer College Chiropractic - Davenport, 2017
Medicare assignment: Accepts the Medicare-approved amount as payment in full
Group practices: Saunders County Chiropractic and Acupuncture, PC (2 clinicians)

Practice addresses (Care Compare)

1320 E 31St St
Wahoo, NE 68066-5581
Phone (402) 277-7180

Medicare participation

Medicare fee-for-service enrollment: Enrolled in NE

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
I20171122002355	NE	Practitioner - Chiropractic	1456618628	Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD): Yes

State licenses

License	State	Type	Specialty
1955	NE	MD	Dental Hygienist

Practice roles (1 of 5)

Organization	Specialty	Status	New patients
Saunders County Chiropractic & Acupuncture, PC	Chiropractor	Current since Jul 21, 2018	Accepting new patients

Locations

1320 E 31st St
Wahoo, NE 68066
Phone (402) 277-5091

1320 E 31st St
Ste 1
Wahoo, NE 68066

Networks

IA HMO C-SNP
IA HMO
devoted network organization-a4751131-f16f-4e82-8f2b-b08e66379a7a
CO HMO

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Chiropractor	111N00000X	1955	NE	Yes

Addresses

Primary practice location

1320 E 31St St
Wahoo, NE 68066-5581

Mailing address

1909 Sutton Dr
Wahoo, NE 68066-4131
Phone (402) 443-9429

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Nov 2, 2023.

{
    "created_epoch": "1508976000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698883200000",
    "number": "1043722309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1909 SUTTON DR",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680664131",
            "telephone_number": "402-443-9429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 E 31ST ST",
            "city": "WAHOO",
            "state": "NE",
            "postal_code": "680665581",
            "telephone_number": "024-277-7180",
            "fax_number": "402-277-7182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHVATAL",
        "first_name": "KEITH",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-26",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wahoo, NE

All providers in Wahoo, NE · Chiropractor in Nebraska

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 2, 2023. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
Medicare Care Compare provider data (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.