Avenue Chiropractic & Wellness Clinic, PC
Organization Active NPI Chiropractor · Columbus, NE
NPI 1194914945 · NPPES record last updated Oct 28, 2015
Key facts
- NPI
- 1194914945
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 952 (NE)
- Legal business name
- AVENUE CHIROPRACTIC & WELLNESS CLINIC, PC
- Practice address
- 2559 37TH Ave
Columbus, NE 68601-2359 - Phone
- (402) 564-7514
- Fax
- (402) 564-3439
- NPI assigned
- Oct 17, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Ralph B Crabtree, D.C.
- Title
- Owner
- Phone
- (402) 564-7514
Practitioners 1
-
Ralph B Crabtree, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NE
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090416000535 | NE | Part B Supplier - Clinic/Group Practice | 2668529215 |
Receives reassigned benefits from 1 practitioner Practice locations: Columbus, NE |
National Provider Directory
Locations
2559 37th Ave
Columbus, NE 68601
Phone (402) 562-7133
Interoperability endpoints
- bruce@acwc0005.direct.chirotouch.md
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 952 | NE | Yes |
Addresses
Primary practice location
2559 37TH Ave
Columbus, NE 68601-2359
Mailing address
PO Box 673
Columbus, NE 68602-0673
Phone (402) 564-7514
Other providers in Columbus, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 28, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.