Individual provider Active NPI

David James Iacuone, D.C.

  • Chiropractor
  • Phoenix, AZ
National Provider Identifier
1104854520
Registry record updated Jun 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
7701 Issued in AZ
Practice address
720 E Thunderbird Rd Ste 1
Phoenix, AZ 85022-5396
Phone
(602) 439-1515
Fax
(602) 439-1535
NPI assigned
Jun 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 7701 AZ Primary

Addresses

Primary practice location

720 E Thunderbird Rd Ste 1
Phoenix, AZ 85022-5396

Mailing address

720 E Thunderbird Rd Ste 1
Phoenix, AZ 85022-5396
Phone (602) 439-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060803000048 AZ Practitioner - ChiropracticPractitioner - Physical Medicine and Rehabilitation 3173558574 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
ChiropracticAlso: Physical Medicine and Rehabilitation
Education
Logan College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ki HoldingsGroup PAC ID 8729122544, 2 clinicians

Practice addresses (Care Compare)

720 E Thunderbird Rd
Suite 1
Phoenix, AZ 85022-5396
Phone (602) 439-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7701AZMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ki Holdings Chiropractor CurrentSince May 9, 2010 Accepting new patients
KP Chiropractic PC Chiropractor Past Accepting new patients
Activator Health Center Chiropractor Past Accepting new patients
Mainland Chiropractic Clinic, LLC Chiropractor Past Accepting new patients

Locations

720 E Thunderbird Rd
Ste 1
Phoenix, AZ 85022
Phone (602) 439-1515

Organizations & group practices 4

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": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1275523200000",
    "number": "1104854520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 E THUNDERBIRD RD STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850225396",
            "telephone_number": "602-439-1515",
            "fax_number": "602-439-1535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 E THUNDERBIRD RD STE 1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850225396",
            "telephone_number": "602-439-1515",
            "fax_number": "602-439-1535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IACUONE",
        "first_name": "DAVID",
        "middle_name": "JAMES",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2010-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "AZ",
            "license": "7701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Phoenix, AZ

Sources for this page

Verify at the official NPI Registry.