Organization Active NPI

Swella Clinic of Chiropractic, P.C.

  • Chiropractor
  • Decorah, IA
National Provider Identifier
1063675809
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05780 Issued in IA
Legal business name
SWELLA CLINIC OF CHIROPRACTIC, P.C.
Practice address
810 S Mechanic St
Decorah, IA 52101-2146
Phone
(563) 382-3801
Fax
(563) 387-0004
NPI assigned
Jul 2, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Authorized official

Name
Dr. Rebecca Jo Swella Smedsrud, D.C.NPI 1811977473
Title
Chiropractor/Owner
Phone
(563) 382-3801

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X A05780 IA Primary

Addresses

Primary practice location

810 S Mechanic St
Decorah, IA 52101-2146

Mailing address

810 S Mechanic St
Decorah, IA 52101-2146
Phone (563) 382-3801

Other identifiers 2

IdentifierTypeStateIssuer
15201OtherIAWELLMARK
1811977473OtherIANPI INDIVIDUAL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080929000351 IA Part B Supplier - Clinic/Group Practice 1254408511 Receives reassigned benefits from 1 practitioner
Practice locations: Decorah, IA

National Provider Directory

National Provider Directory

Locations

810 S Mechanic St
Decorah, IA 52101
Phone (563) 382-3801

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1214956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214956800000",
    "number": "1063675809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S MECHANIC ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012146",
            "telephone_number": "563-382-3801",
            "fax_number": "563-387-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S MECHANIC ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012146",
            "telephone_number": "563-382-3801",
            "fax_number": "563-387-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SWELLA CLINIC OF CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-02",
        "last_updated": "2008-07-02",
        "status": "A",
        "authorized_official_last_name": "SWELLA SMEDSRUD",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "CHIROPRACTOR/OWNER",
        "authorized_official_telephone_number": "563-382-3801",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "15201",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI INDIVIDUAL",
            "identifier": "1811977473",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decorah, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.