Keokuk Chiropractic & Sports Injury Center, Inc.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

Legal business name

KEOKUK CHIROPRACTIC & SPORTS INJURY CENTER, INC.

Practice address

924 Main St
Keokuk, IA 52632-4655

Phone

(319) 524-0905

NPI assigned

Jan 10, 2008

Organization subpart

No

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

Authorized official

Name

Dennis E. WolterNPI 1144249418

Title

President

Phone

(319) 524-0905

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dennis E. Wolter, D.C.

  • Sports Physician Chiropractor
  • Keokuk, IA
  • NPI 1144249418
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1199923200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199923200000",
    "number": "1104002013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "924 MAIN ST",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526324655",
            "telephone_number": "319-524-0905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 MAIN ST",
            "city": "KEOKUK",
            "state": "IA",
            "postal_code": "526324655",
            "telephone_number": "319-524-0905"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEOKUK CHIROPRACTIC & SPORTS INJURY CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-10",
        "last_updated": "2008-01-10",
        "status": "A",
        "authorized_official_last_name": "WOLTER",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-524-0905"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "52935",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRIGON",
            "identifier": "615537",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Keokuk Area Hospital
• Keokuk Area Hospital
• Keokuk Area Hospital
• Keokuk Area Medical Equipment & Supply, Inc.
• Keokuk C.S.D.
• Keokuk Fire Department, City of Keokuk
• Jacob Sung Sik Keum, D.O.
• Kevan S. Zechin, M.D.
• Kircher Family Dentistry
• Edward Lawrence Kircher, D.D.S.

• Sports Physician Chiropractor in Keokuk, IA
• Providers in Keokuk, IA by specialty
• Sports Physician Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.