Individual provider Active NPI

Shawn Gerard

  • Chiropractor
  • Eldridge, IA
National Provider Identifier
1154706265
Registry record updated Sep 1, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
078973 Issued in IA
Practice address
112W Davenport St 1
Eldridge, IA 52748-1252
Phone
(563) 223-9120
NPI assigned
Jul 30, 2015
Last updated
Sep 1, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 078973 IA Primary
Sports Physician Chiropractor 111NS0005X 078973 IA

Addresses

Primary practice location

112W Davenport St 1
Eldridge, IA 52748-1252

Mailing address

112 W Davenport St Unit 1
Eldridge, IA 52748-1252
Phone (563) 223-9120

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151001002686 IA Practitioner - Chiropractic 9638487184 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

208 W Franklin St
Unit 1
Eldridge, IA 52748-1242
Phone (563) 223-9120

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078973IAMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Gerard Chiropractic Chiropractor CurrentSince Sep 1, 2015 Accepting new patients

Locations

208 W Franklin St
Unit 1
Eldridge, IA 52748
Phone (563) 223-9120

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1438214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441065600000",
    "number": "1154706265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 W DAVENPORT ST UNIT 1",
            "city": "ELDRIDGE",
            "state": "IA",
            "postal_code": "527481252",
            "telephone_number": "563-223-9120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112W DAVENPORT ST 1",
            "city": "ELDRIDGE",
            "state": "IA",
            "postal_code": "527481252",
            "telephone_number": "563-223-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERARD",
        "first_name": "SHAWN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-30",
        "last_updated": "2015-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "078973",
            "primary": true
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IA",
            "license": "078973",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eldridge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.