NPIMap

Organization Active NPI

Reibly Chiropractic Inc

  • Chiropractor
  • Peru, IN
National Provider Identifier
1073858874
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
08001459A Issued in IN
Legal business name
REIBLY CHIROPRACTIC INC
Practice address
210 Boulevard
Peru, IN 46970-1620
Phone
(765) 473-8824
Fax
(765) 473-8825
NPI assigned
Dec 5, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Authorized official

Name
Dr. Jon E Reibly, D.C.NPI 1447385059
Title
Doctor/ Owner
Phone
(765) 473-8824

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 08001459A IN Primary

Addresses

Primary practice location

210 Boulevard
Peru, IN 46970-1620

Mailing address

PO Box 1044
Peru, IN 46970-4044
Phone (765) 473-8824

Other identifiers 3

IdentifierTypeStateIssuer
350055708OtherINRAILROAD MEDICARE
000000184945OtherINANTHEM BC/BS
100179590AMedicaidIN

National Provider Directory

National Provider Directory

Locations

210 Boulevard
Peru, IN 46970
Phone (317) 473-8824

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": "1354665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1073858874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1044",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469704044",
            "telephone_number": "765-473-8824",
            "fax_number": "765-473-8825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 BOULEVARD",
            "city": "PERU",
            "state": "IN",
            "postal_code": "469701620",
            "telephone_number": "765-473-8824",
            "fax_number": "765-473-8825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REIBLY CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-05",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "REIBLY",
        "authorized_official_first_name": "JON",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "DOCTOR/ OWNER",
        "authorized_official_telephone_number": "765-473-8824",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "08001459A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350055708",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000184945",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100179590A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peru, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.