Brea Newell Danner, DC
Individual provider Active NPI Chiropractor · Grimes, IA
NPI 1083117477 · NPPES record last updated Mar 13, 2018
Key facts
- NPI
- 1083117477
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 091094 (IA)
- Practice address
- 241 SE Destination Dr Ste 300
Grimes, IA 50111-8901 - Phone
- (515) 745-3142
- NPI assigned
- Mar 13, 2018
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091094 | IA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revive Chiropractic Inc. | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 091094 | IA | Yes |
Addresses
Primary practice location
241 SE Destination Dr Ste 300
Grimes, IA 50111-8901
Mailing address
241 SE Destination Dr Ste 300
Grimes, IA 50111-8901
Other providers in Grimes, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.