Organization Active NPI

Spine & Sport Chiropractic Center, P.C.

  • Chiropractor
  • Dubuque, IA
National Provider Identifier
1174814693
Registry record updated May 2, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
SPINE & SPORT CHIROPRACTIC CENTER, P.C.
Practice address
4840 Asbury Rd
Dubuque, IA 52002-0480
Phone
(563) 564-9490
NPI assigned
May 2, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 2, 2011

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

Authorized official

Name
Dr. Joshua Emory Nagle, D.C.NPI 1265723878
Title
Doctor
Phone
(563) 564-9490

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 Primary

Addresses

Primary practice location

4840 Asbury Rd
Dubuque, IA 52002-0480

Mailing address

4840 Asbury Rd
Dubuque, IA 52002-0480
Phone (563) 564-9490

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110607000312 IA Part B Supplier - Clinic/Group Practice 2062699796 Receives reassigned benefits from 3 practitioners
Practice locations: Dubuque, IA

National Provider Directory

National Provider Directory

Locations

4840 Asbury Rd
Ste 102
Dubuque, IA 52002
Phone (563) 845-0033

4840 Asbury Rd
Ste 5
Dubuque, IA 52002
Phone (563) 845-0033

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": "1304294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1304294400000",
    "number": "1174814693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4840 ASBURY RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520020480",
            "telephone_number": "563-564-9490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4840 ASBURY RD",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520020480",
            "telephone_number": "563-564-9490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & SPORT CHIROPRACTIC CENTER, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-02",
        "last_updated": "2011-05-02",
        "status": "A",
        "authorized_official_last_name": "NAGLE",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "EMORY",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "563-564-9490",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dubuque, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2011; 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.