Individual provider Active NPI

Martin Stine, D.C.

  • Neurology Chiropractor
  • Davenport, IA
National Provider Identifier
1053416180
Registry record updated Feb 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
A06075 Issued in IA
Practice address
400 N Main St
Suite 104
Davenport, IA 52801-1417
Phone
(563) 324-8888
Fax
(563) 324-8888
NPI assigned
Sep 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Chiropractor 111NN0400X A06075 IA Primary

Addresses

Primary practice location

400 N Main St
Suite 104
Davenport, IA 52801-1417

Mailing address

400 N Main St
Suite 104
Davenport, IA 52801-1417
Phone (563) 324-8888

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150804004053 CO Practitioner - Chiropractic 1456398528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1997
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1226 W Ash St
Suite a
Windsor, CO 80550-4657
Phone (970) 460-0168

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Stine Chiropractic Health and Wellness Clinic, P.C. PastSince Jan 1, 2002 Accepting new patients
Rocky Mountain Chiropractic and Sports Injury Centers Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328832000000",
    "number": "1053416180",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "address_2": "SUITE 104",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011417",
            "telephone_number": "563-324-8888",
            "fax_number": "563-324-8888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N MAIN ST",
            "address_2": "SUITE 104",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528011417",
            "telephone_number": "563-324-8888",
            "fax_number": "563-324-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STINE",
        "first_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2012-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Neurology",
            "state": "IA",
            "license": "A06075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2012; 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.