Organization Active NPI

Healthy Lifestyles Chiropractic LLC

  • Chiropractor
  • Ames, IA
National Provider Identifier
1114928488
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06382 Issued in IA
Legal business name
HEALTHY LIFESTYLES CHIROPRACTIC LLC
Practice address
213 N Duff Ave
Ste 5
Ames, IA 50010-6676
Phone
(515) 233-2217
Fax
(515) 233-4208
NPI assigned
Aug 9, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Authorized official

Name
Mrs. Shanon L McKinley II
Title
Office Manager
Phone
(515) 233-2217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 06382 IA Primary

Addresses

Primary practice location

213 N Duff Ave
Ste 5
Ames, IA 50010-6676

Mailing address

213 N Duff Ave
Ste 5
Ames, IA 50010-6676
Phone (515) 233-2217

Other identifiers 1

IdentifierTypeStateIssuer
0224972MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130401000070 IA Part B Supplier - Clinic/Group Practice 2567607260 Receives reassigned benefits from 1 practitioner
Practice locations: Ames, IA

National Provider Directory

National Provider Directory

Locations

213 Duff Ave
Ste 5
Ames, IA 50010
Phone (515) 233-2217

Practitioners & affiliated clinicians

Practitioners 1

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": "1123545600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1114928488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 N DUFF AVE",
            "address_2": "STE 5",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500106676",
            "telephone_number": "515-233-2217",
            "fax_number": "515-233-4208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 N DUFF AVE",
            "address_2": "STE 5",
            "city": "AMES",
            "state": "IA",
            "postal_code": "500106676",
            "telephone_number": "515-233-2217",
            "fax_number": "515-233-4208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHY LIFESTYLES CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-09",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "MCKINLEY",
        "authorized_official_first_name": "SHANON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "515-233-2217",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_name_suffix": "II"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06382",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0224972",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ames, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.