Organization Active NPI

Heartland Chiropractic Center LLC

  • Chiropractor
  • Jackson, MO
National Provider Identifier
1144763756
Registry record updated Apr 3, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2016026188 Issued in MO
Legal business name
HEARTLAND CHIROPRACTIC CENTER LLC
Practice address
3874 E Jackson Blvd
Jackson, MO 63755-3710
Phone
(573) 243-8983
Fax
(573) 243-7209
NPI assigned
Nov 30, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2017

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

Authorized official

Name
Dr. Mandi Wood, DCNPI 1184171282
Title
Owner
Phone
(573) 243-7246

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 2016026188 MO Primary

Addresses

Primary practice location

3874 E Jackson Blvd
Jackson, MO 63755-3710

Mailing address

3874 E Jackson Blvd
Jackson, MO 63755-3710
Phone (573) 243-8983

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170331001109 MO Part B Supplier - Clinic/Group Practice 1557646668 Receives reassigned benefits from 2 practitioners
Practice locations: Jackson, MO

National Provider Directory

National Provider Directory

Locations

3874 E Jackson Blvd
Jackson, MO 63755
Phone (573) 243-8983

Practitioners & affiliated clinicians

Practitioners 3

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": "1480464000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1144763756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3874 E JACKSON BLVD",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637553710",
            "telephone_number": "573-243-8983",
            "fax_number": "573-243-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3874 E JACKSON BLVD",
            "city": "JACKSON",
            "state": "MO",
            "postal_code": "637553710",
            "telephone_number": "573-243-8983",
            "fax_number": "573-243-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND CHIROPRACTIC CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-30",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "WOOD",
        "authorized_official_first_name": "MANDI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-243-7246",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2016026188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.