Individual provider Active NPI

Troy Allen Reistroffer, D.C.

  • Chiropractor
  • Crete, NE
National Provider Identifier
1104838259
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1311 Issued in NE
Practice address
307 E 12TH St
Crete, NE 68333-2234
Phone
(402) 826-2191
Fax
(402) 826-4855
NPI assigned
Aug 13, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1311 NE Primary

Addresses

Primary practice location

307 E 12TH St
Crete, NE 68333-2234

Mailing address

307 E 12TH St
Crete, NE 68333-2234
Phone (402) 826-2191

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150729007941 MS Practitioner - Chiropractic 2567512445 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Desoto County Chiropractic IncGroup PAC ID 4981918463, 2 clinicians

Practice addresses (Care Compare)

1134 Church Rd W
Southaven, MS 38671-7144
Phone (662) 393-4848

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1311NEMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Desoto County Chiropractic, Inc. CurrentSince May 26, 2015 Accepting new patients

Locations

1134 Church Rd W
Southaven, MS 38671
Phone (662) 393-4848

Networks

  • LA PPO C-SNP

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": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104838259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E 12TH ST",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683332234",
            "telephone_number": "402-826-2191",
            "fax_number": "402-826-4855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E 12TH ST",
            "city": "CRETE",
            "state": "NE",
            "postal_code": "683332234",
            "telephone_number": "402-826-2191",
            "fax_number": "402-826-4855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISTROFFER",
        "first_name": "TROY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crete, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.