NPIMap

Organization Active NPI

Etio LLC

Doing business as Etio Chiropractic

  • Chiropractor
  • Colorado Springs, CO
National Provider Identifier
1205318284
Registry record updated Sep 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ETIO LLC
Doing business as
Etio Chiropractic
Practice address
3586 Hartsel Dr Ste 12E
Colorado Springs, CO 80920-2112
Phone
(719) 627-3846
NPI assigned
Sep 5, 2018
Last updated
Sep 5, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2018

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

Authorized official

Name
Dr. Kent Daavettila, DCNPI 1396227377
Title
Owner
Phone
(719) 627-3846

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

3586 Hartsel Dr Ste 12E
Colorado Springs, CO 80920-2112

Mailing address

3586 Hartsel Dr Ste 12E
Colorado Springs, CO 80920-2112
Phone (719) 627-3846

Other names 1

  • Etio Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180921002446 CO Part B Supplier - Clinic/Group Practice 6901157494 Receives reassigned benefits from 2 practitioners
Practice locations: Colorado Springs, CO

National Provider Directory

National Provider Directory

Locations

3586 Hartsel Dr
Ste 12E
Colorado Springs, CO 80920
Phone (719) 627-3846

3586 Hartsel Dr
Ste E
Colorado Springs, CO 80920
Phone (719) 627-3846

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1536105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536105600000",
    "number": "1205318284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3586 HARTSEL DR STE 12E",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202112",
            "telephone_number": "719-627-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3586 HARTSEL DR STE 12E",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809202112",
            "telephone_number": "719-627-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ETIO LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-05",
        "last_updated": "2018-09-05",
        "status": "A",
        "authorized_official_last_name": "DAAVETTILA",
        "authorized_official_first_name": "KENT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "719-627-3846",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Etio Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Colorado Springs, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2018; 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.