Active Chiropractic P C

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

A06166 Issued in IA

Legal business name

ACTIVE CHIROPRACTIC P C

Practice address

1001 13TH Ave N
Clinton, IA 52732-3403

Phone

(563) 242-9343

NPI assigned

Feb 10, 2014

Organization subpart

No

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

Authorized official

Name

Brian R Dornbush, D.C.NPI 1568499580

Title

President

Phone

(563) 242-9343

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Brian R Dornbush, D.C.

  • Sports Physician Chiropractor
  • Clinton, IA
  • NPI 1568499580

  IA, Sports Physician

  Medicare reassignment NPD Authorized official
• Steven E Craig, DPM

  • Podiatrist
  • Midvale, UT
  • NPI 1073512448
  NPD (past)

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

{
    "created_epoch": "1391990400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1391990400000",
    "number": "1194149203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527323403",
            "telephone_number": "563-242-9343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527323403",
            "telephone_number": "563-242-9343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVE CHIROPRACTIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-02-10",
        "last_updated": "2014-02-10",
        "status": "A",
        "authorized_official_last_name": "DORNBUSH",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-242-9343",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Sports Physician",
            "state": "IA",
            "license": "A06166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2180513",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mindy Lou Abbott-Stratton, LISW IADC,
• Advanced Podiatry, Inc.
• Anoop Aggarwal, M.D.
• Ahmed Elahmady PC
• Ahmed Elahmady PC
• Ahmed Elahmady PC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2014; 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.