Kenneth Daniel Womboldt Jr., D.C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

007584 Issued in IA

Practice address

1721 N 2ND St
Clinton, IA 52732-2644

Phone

(563) 242-5515

Fax

(563) 242-0765

NPI assigned

Mar 23, 2011

Last updated

Jul 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Alternative Wellness & Chiropractic Center PC

  • Chiropractor
  • Clinton, IA
  • NPI 1750634481
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657584000000",
    "number": "1184923690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1721 N 2ND ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527322644",
            "telephone_number": "563-242-5515",
            "fax_number": "563-242-0765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1721 N 2ND ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527322644",
            "telephone_number": "563-242-5515",
            "fax_number": "563-242-0765"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOMBOLDT",
        "first_name": "KENNETH",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-23",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1660",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brandon Winter, DDS
• Terry Allen Winter, D.D.S
• Samantha Winters
• Susan Wolever, IADC
• Margaret C Wolf, M.D.
• Womens Care Specialists PC
• Womens Health Services of Eastern Iowa Inc (Women's Health Services)
• Womens Health Services of Eastern Iowa Inc (Womens Health Services)
• Tara Wood, RN
• Dorshea Woodfork, LPN

• Chiropractor in Clinton, IA
• Providers in Clinton, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; 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.