Individual provider Active NPI

Elizabeth Ann Fitzgerald, D.C.

  • Chiropractor
  • Clive, IA
National Provider Identifier
1104095371
Registry record updated May 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007013 Issued in IA
Practice address
8814 Swanson Blvd
Suite C
Clive, IA 50325-6910
Phone
(515) 314-3419
NPI assigned
Feb 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 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 007013 IA Primary

Addresses

Primary practice location

8814 Swanson Blvd
Suite C
Clive, IA 50325-6910

Mailing address

3631 SW 34TH St
Des Moines, IA 50321-1937
Phone (515) 314-3419

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090624000124 IA Practitioner - Chiropractic 2961553409 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8814 Swanson Blvd
Suite C
Clive, IA 50325-6910
Phone (515) 225-6877

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007013IAMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Total Body Chiropractic LLC Chiropractor CurrentSince Jul 1, 2009 Accepting new patients

Locations

8814 Swanson Blvd
Ste C
Clive, IA 50325
Phone (515) 225-6877

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": "1203552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242345600000",
    "number": "1104095371",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3631 SW 34TH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503211937",
            "telephone_number": "515-314-3419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8814 SWANSON BLVD",
            "address_2": "SUITE C",
            "city": "CLIVE",
            "state": "IA",
            "postal_code": "503256910",
            "telephone_number": "515-314-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-21",
        "last_updated": "2009-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clive, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 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.