Individual provider Active NPI

Isaac Stansbury, DC

  • Chiropractor
  • Kearney, NE
National Provider Identifier
1053198663
Registry record updated Sep 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2172 Issued in NE
Practice address
4715 2ND Ave
Kearney, NE 68847-2417
Phone
(308) 455-1500
NPI assigned
Sep 8, 2023
Last updated
Sep 8, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2172 NE Primary

Addresses

Primary practice location

4715 2ND Ave
Kearney, NE 68847-2417

Mailing address

1315 W 112TH St
Kearney, NE 68845-1436
Phone (308) 293-5534

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231102003745 NE Practitioner - Chiropractic 5092162693 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Chiropractic and Tissue Rehabilitation LLCGroup PAC ID 2961682794, 5 clinicians

Practice addresses (Care Compare)

4715 2ND Ave
Kearney, NE 68847-2417
Phone (308) 455-1500

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2172NEMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Chiropractic & Tissue Rehabilitation, LLC CurrentSince Oct 31, 2023 Accepting new patients

Locations

4715 2nd Ave
Kearney, NE 68847
Phone (308) 455-1500

Networks

  • IA HMO
  • CO HMO
  • IA HMO C-SNP

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, 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": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1053198663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 W 112TH ST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688451436",
            "telephone_number": "308-293-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4715 2ND AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688472417",
            "telephone_number": "308-455-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANSBURY",
        "first_name": "ISAAC",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-09-08",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "2172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.