Individual provider Active NPI

Theodore Crispin Semelroth, D.C.

  • Chiropractor
  • Hiawatha, IA
National Provider Identifier
1063749562
Registry record updated Nov 4, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007252 Issued in IA
Practice address
1450 Boyson Rd
Ste B4
Hiawatha, IA 52233-2340
Phone
(319) 378-0562
Fax
(319) 378-3904
NPI assigned
Nov 4, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007252 IA Primary

Addresses

Primary practice location

1450 Boyson Rd
Ste B4
Hiawatha, IA 52233-2340

Mailing address

1450 Boyson Rd
Ste B4
Hiawatha, IA 52233-2340
Phone (319) 378-0562

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100130000005 IA Practitioner - Chiropractic 6406999457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1450 Boyson Rd
Suite B4
Hiawatha, IA 52233-2321
Phone (319) 378-0562

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Boyson Chiropractic, P.C. Chiropractor CurrentSince Nov 15, 2009 Accepting new patients

Locations

1450 Boyson Rd
Ste B4
Hiawatha, IA 52233
Phone (319) 378-0562

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1257292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257292800000",
    "number": "1063749562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 BOYSON RD",
            "address_2": "STE B4",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332340",
            "telephone_number": "319-378-0562",
            "fax_number": "319-378-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BOYSON RD",
            "address_2": "STE B4",
            "city": "HIAWATHA",
            "state": "IA",
            "postal_code": "522332340",
            "telephone_number": "319-378-0562",
            "fax_number": "319-378-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEMELROTH",
        "first_name": "THEODORE",
        "middle_name": "CRISPIN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-04",
        "last_updated": "2009-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007252",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiawatha, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2009; 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.