Organization Active NPI

Eldora Family Chiropractic & Wellness Center PC

Doing business as Eldora Chiropractic Center

  • Chiropractor
  • Eldora, IA
National Provider Identifier
1124411483
Registry record updated Mar 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
076507 Issued in IA
Legal business name
ELDORA FAMILY CHIROPRACTIC & WELLNESS CENTER PC
Doing business as
Eldora Chiropractic Center
Practice address
1376 Washington St
Eldora, IA 50627-1631
Phone
(641) 939-3831
NPI assigned
Mar 11, 2015
Last updated
Mar 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2015

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

Authorized official

Name
Dr. Zachary Michael Stoulil, D.C.NPI 1689064263
Title
President
Phone
(515) 368-3790

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
Chiropractor 111N00000X 076507 IA Primary

Addresses

Primary practice location

1376 Washington St
Eldora, IA 50627-1631

Mailing address

1376 Washington St
Eldora, IA 50627-1631

Other names 1

  • Eldora Chiropractic Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150511000927 IA Part B Supplier - Clinic/Group Practice 0143549311 Receives reassigned benefits from 2 practitioners
Practice locations: Eldora, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1426032000000",
    "number": "1124411483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1376 WASHINGTON ST",
            "city": "ELDORA",
            "state": "IA",
            "postal_code": "506271631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1376 WASHINGTON ST",
            "city": "ELDORA",
            "state": "IA",
            "postal_code": "506271631",
            "telephone_number": "641-939-3831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELDORA FAMILY CHIROPRACTIC & WELLNESS CENTER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-11",
        "last_updated": "2015-03-11",
        "status": "A",
        "authorized_official_last_name": "STOULIL",
        "authorized_official_first_name": "ZACHARY",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-368-3790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "076507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eldora Chiropractic Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Eldora, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2015; 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.