Individual provider Active NPI

Jacob Ryan Segebart, D.C.

  • Chiropractor
  • Harlan, IA
National Provider Identifier
1205124013
Registry record updated Jul 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007440 Issued in IA
Practice address
515 Court St
Harlan, IA 51537-1439
Phone
(712) 733-4545
NPI assigned
Jul 13, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007440 IA Primary

Addresses

Primary practice location

515 Court St
Harlan, IA 51537-1439

Mailing address

1305 Brummer Dr
Denison, IA 51442-2828
Phone (712) 790-1497

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110815000831 IA Practitioner - Chiropractic 5698944304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1607 4TH Ave S
Denison, IA 51442-2063
Phone (712) 263-6546

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007440IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Segebart Chiropractic PLLC Chiropractor CurrentSince Jan 2, 2012 Accepting new patients
Cedar Valley Medical Specialists PC Past Accepting new patients
Pitts Family & Sports Chiropractic CTRS PC Chiropractor PastSince Feb 1, 2003 Accepting new patients

Locations

1607 4th Ave S
Denison, IA 51442
Phone (712) 263-6546

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1310515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1310515200000",
    "number": "1205124013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 BRUMMER DR",
            "city": "DENISON",
            "state": "IA",
            "postal_code": "514422828",
            "telephone_number": "712-790-1497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 COURT ST",
            "city": "HARLAN",
            "state": "IA",
            "postal_code": "515371439",
            "telephone_number": "712-733-4545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEGEBART",
        "first_name": "JACOB",
        "middle_name": "RYAN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-13",
        "last_updated": "2011-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Harlan, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2011; 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.