Organization Active NPI

Cullinan Chiropractic P C

  • Chiropractor
  • Tama, IA
National Provider Identifier
1205807732
Registry record updated Dec 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06440 Issued in IA
Legal business name
CULLINAN CHIROPRACTIC P C
Practice address
1210 State St
Tama, IA 52339-1640
Phone
(641) 484-8600
Fax
(641) 484-8700
NPI assigned
Feb 1, 2006
Last updated
Dec 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2012

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

Authorized official

Name
Dr. Barry CullinanNPI 1346212719
Title
Owner
Phone
(641) 484-8600

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 06440 IA Primary

Addresses

Primary practice location

1210 State St
Tama, IA 52339-1640

Mailing address

1210 State St
Tama, IA 52339-1640
Phone (641) 484-8600

Other identifiers 1

IdentifierTypeStateIssuer
0255471MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040405001716 IA Part B Supplier - Clinic/Group Practice 2961495064 Receives reassigned benefits from 1 practitioner
Practice locations: Tama, IA

National Provider Directory

National Provider Directory

Locations

1210 State St
Tama, IA 52339
Phone (641) 484-8600

Practitioners & affiliated clinicians

Practitioners 2

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": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354665600000",
    "number": "1205807732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 STATE ST",
            "city": "TAMA",
            "state": "IA",
            "postal_code": "523391640",
            "telephone_number": "641-484-8600",
            "fax_number": "641-484-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1210 STATE ST",
            "city": "TAMA",
            "state": "IA",
            "postal_code": "523391640",
            "telephone_number": "641-484-8600",
            "fax_number": "641-484-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CULLINAN CHIROPRACTIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2012-12-05",
        "status": "A",
        "authorized_official_last_name": "CULLINAN",
        "authorized_official_first_name": "BARRY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "641-484-8600",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0255471",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tama, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2012; 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.