Integrative Chiropractic and Functional Medicine Clinic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INTEGRATIVE CHIROPRACTIC AND FUNCTIONAL MEDICINE CLINIC, LLC

Practice address

11922 Standing Stone Dr Ste 200
Gretna, NE 68028-3887

Phone

(785) 259-3700

NPI assigned

Oct 6, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Dean Hedlund, DCNPI 1275198384

Title

Owner/Chiropractor

Phone

(785) 259-3700

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 1

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

• Kyle Dean Hedlund, DC

  • Chiropractor
  • Elkhorn, NE
  • NPI 1275198384
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1063019792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11922 STANDING STONE DR STE 200",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680283887",
            "telephone_number": "785-259-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11922 STANDING STONE DR STE 200",
            "city": "GRETNA",
            "state": "NE",
            "postal_code": "680283887",
            "telephone_number": "785-259-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATIVE CHIROPRACTIC AND FUNCTIONAL MEDICINE CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "HEDLUND",
        "authorized_official_first_name": "KYLE",
        "authorized_official_middle_name": "DEAN",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "785-259-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bailey Howell
• Amy Huckins
• Shakila Hussaini
• Carmella N Imig, M.D.
• Madison Ingram
• Michael Irwin
• Ryan Bruce Isherwood, M.D.
• Ashley Izuegbunam, LMHP
• Brianna Jackson
• Nicole Jacobson

• Chiropractor in Gretna, NE
• Providers in Gretna, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.