Individual provider Active NPI

Lindsay Jo Gall, DC

  • Chiropractor
  • Bettendorf, IA
National Provider Identifier
1174788442
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007109 Issued in IA
Practice address
2377 Cumberland Square Dr
Bettendorf, IA 52722-3251
Phone
(563) 359-9541
Fax
(563) 344-3914
NPI assigned
Jul 25, 2008
Last updated
Jan 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007109 IA Primary

Addresses

Primary practice location

2377 Cumberland Square Dr
Bettendorf, IA 52722-3251

Mailing address

2377 Cumberland Square Dr
Bettendorf, IA 52722-3251
Phone (563) 359-9541

Other identifiers 4

IdentifierTypeStateIssuer
I11500OtherIAMEDICARE GROUP
I11500002OtherIAMEDICARE INDIVIDUAL
0202619MedicaidIA
1174788442OtherIAWELLMARK

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080913000166 IA Practitioner - Chiropractic 3375619414 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bettendorf Chiropractic Wellness Center Inc.Group PAC ID 6002931359, 3 clinicians

Practice addresses (Care Compare)

4893 Utica Ridge Rd
Suite 101
Davenport, IA 52807-3081
Phone (563) 359-5600

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007109IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nelson Chiropractic Systems, P.C. Chiropractor CurrentSince Jul 15, 2008 Accepting new patients
Bettendorf Chiropractic Wellness Center Inc. Chiropractor CurrentSince Sep 1, 2021 Accepting new patients
Galesburg Wellness Systems P.C. Chiropractor PastSince Jul 15, 2008 Accepting new patients

Locations

2377 Cumberland Square Dr
Bettendorf, IA 52722
Phone (563) 359-4541

4893 Utica Ridge Rd
Ste 101
Davenport, IA 52807
Phone (563) 359-5600

Organizations & group practices 3

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": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1174788442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2377 CUMBERLAND SQUARE DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223251",
            "telephone_number": "563-359-9541",
            "fax_number": "563-344-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2377 CUMBERLAND SQUARE DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223251",
            "telephone_number": "563-359-9541",
            "fax_number": "563-344-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALL",
        "first_name": "LINDSAY",
        "middle_name": "JO",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007109",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "I11500",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE INDIVIDUAL",
            "identifier": "I11500002",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0202619",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "1174788442",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2012; 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.