Individual provider Active NPI

Chad Al Collins, DC

  • Chiropractor
  • Hampton, IA
National Provider Identifier
1053391631
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05485 Issued in IA
Practice address
303 Central Ave E
Hampton, IA 50441
Phone
(641) 456-4142
Fax
(641) 456-2777
NPI assigned
Jan 19, 2006
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05485 IA Primary

Addresses

Primary practice location

303 Central Ave E
Hampton, IA 50441

Mailing address

303 Central Ave E
Hampton, IA 50441
Phone (641) 456-4142

Other identifiers 1

IdentifierTypeStateIssuer
0065060MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120209000235 IA Practitioner - Chiropractic 0941467500 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Koenen and Collins Chiropractic ClinicGroup PAC ID 3375431901, 2 clinicians

Practice addresses (Care Compare)

303 Central Ave E
Hampton, IA 50441-2025
Phone (641) 456-4142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A05485IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Koenen & Collins Chiropractic Clinic Chiropractor CurrentSince Jul 1, 1990 Accepting new patients

Locations

303 Central Ave E
Hampton, IA 50441
Phone (515) 456-4142

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1053391631",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 CENTRAL AVE E",
            "city": "HAMPTON",
            "state": "IA",
            "postal_code": "50441",
            "telephone_number": "641-456-4142",
            "fax_number": "641-456-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 CENTRAL AVE E",
            "city": "HAMPTON",
            "state": "IA",
            "postal_code": "50441",
            "telephone_number": "641-456-4142",
            "fax_number": "641-456-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLINS",
        "first_name": "CHAD",
        "middle_name": "AL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05485",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0065060",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; 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.