NPIMap

Organization Active NPI

Powell Chiropractic Clinic, PC

  • Neurology Chiropractor
  • Cedar Rapids, IA
National Provider Identifier
1083890982
Registry record updated Mar 4, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
License
A05946 Issued in IA
Legal business name
POWELL CHIROPRACTIC CLINIC, PC
Practice address
1310 Tower LN NE
Cedar Rapids, IA 52402-7488
Phone
(319) 366-2518
Fax
(319) 366-5002
NPI assigned
Jan 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2014

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

Authorized official

Name
Michael Kent Powell, DCNPI 1225000813
Title
Owner
Phone
(319) 366-2518

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X A05972 IA
Neurology ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111NN0400X A05946 IA Primary

Addresses

Primary practice location

1310 Tower LN NE
Cedar Rapids, IA 52402-7488

Mailing address

1310 Tower LN NE
Cedar Rapids, IA 52402-7488
Phone (319) 366-2518

Other identifiers 1

IdentifierTypeStateIssuer
1136267MedicaidIA

Other names 1

  • Powell Chiropractic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040930000136 IA Part B Supplier - Clinic/Group Practice 6709855380 Receives reassigned benefits from 2 practitioners
Practice locations: Cedar Rapids, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393891200000",
    "number": "1083890982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1310 TOWER LN NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524027488",
            "telephone_number": "319-366-2518",
            "fax_number": "319-366-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1310 TOWER LN NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524027488",
            "telephone_number": "319-366-2518",
            "fax_number": "319-366-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWELL CHIROPRACTIC CLINIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2014-03-04",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "KENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-366-2518",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05972",
            "primary": false
        },
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor, Neurology",
            "state": "IA",
            "license": "A05946",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1136267",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powell Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Mar 4, 2014; 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.