Organization Active NPI

Stinnette Chiropractic Center, P.C.

  • Chiropractor
  • Fremont, NE
National Provider Identifier
1124228192
Registry record updated Jul 18, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1364 Issued in NE
Legal business name
STINNETTE CHIROPRACTIC CENTER, P.C.
Practice address
2155 E 23Rd Ave S
Suite a
Fremont, NE 68025-7849
Phone
(402) 721-0336
Fax
(402) 721-8672
NPI assigned
Jul 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2007

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

Authorized official

Name
Scott Ryan Stinnette, D.C.NPI 1528054590
Title
President/Owner
Phone
(402) 721-0336

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1364 NE Primary

Addresses

Primary practice location

2155 E 23Rd Ave S
Suite a
Fremont, NE 68025-7849

Mailing address

2155 E 23Rd Ave S
Suite a
Fremont, NE 68025-7849
Phone (402) 721-0336

Other identifiers 2

IdentifierTypeStateIssuer
09517OtherNEBLUE CROSS BLUE SHIELD
100251876-00MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041230000716 NE Part B Supplier - Clinic/Group Practice 2466410816 Receives reassigned benefits from 1 practitioner
Practice locations: Fremont, NE

National Provider Directory

National Provider Directory

Locations

2155 E 23rd Ave S
Ste A
Fremont, NE 68025
Phone (402) 721-0336

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": "1184716800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184716800000",
    "number": "1124228192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2155 E 23RD AVE S",
            "address_2": "SUITE A",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257849",
            "telephone_number": "402-721-0336",
            "fax_number": "402-721-8672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2155 E 23RD AVE S",
            "address_2": "SUITE A",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680257849",
            "telephone_number": "402-721-0336",
            "fax_number": "402-721-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STINNETTE CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-18",
        "last_updated": "2007-07-18",
        "status": "A",
        "authorized_official_last_name": "STINNETTE",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "402-721-0336",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1364",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09517",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100251876-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.