Organization Active NPI

Optimal Wellness Chiropractic

  • Health Service Clinic/Center
  • Cedar Rapids, IA
National Provider Identifier
1063101871
Registry record updated Jun 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Service Clinic/CenterTaxonomy code 261QH0100X
Legal business name
OPTIMAL WELLNESS CHIROPRACTIC
Practice address
214 Blairs Ferry Rd NE Unit 2
Cedar Rapids, IA 52402-1602
Phone
(319) 378-1515
NPI assigned
May 8, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2023

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

Authorized official

Name
Ronni Lee Miller, DC
Title
Chiropractor
Phone
(815) 541-7968

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X
Health Service Clinic/Center 261QH0100X Primary

Addresses

Primary practice location

214 Blairs Ferry Rd NE Unit 2
Cedar Rapids, IA 52402-1602

Mailing address

505 Enterprise CT Apt 8
Independence, IA 50644-1233
Phone (815) 541-7968

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230614001562 IA Part B Supplier - Clinic/Group Practice 6901264548 Receives reassigned benefits from 1 practitioner
Practice locations: Cedar Rapids, IA

National Provider Directory

National Provider Directory

Locations

214 Blairs Ferry Rd NE
Cedar Rapids, IA 52402
Phone (319) 378-1515

214 Blairs Ferry Rd NE
Unit 2
Cedar Rapids, IA 52402
Phone (319) 378-1515

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1683504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685577600000",
    "number": "1063101871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "505 ENTERPRISE CT APT 8",
            "city": "INDEPENDENCE",
            "state": "IA",
            "postal_code": "506441233",
            "telephone_number": "815-541-7968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BLAIRS FERRY RD NE UNIT 2",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524021602",
            "telephone_number": "319-378-1515"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMAL WELLNESS CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-08",
        "last_updated": "2023-06-01",
        "certification_date": "2023-06-01",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RONNI",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "815-541-7968",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2023; 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.