Individual provider Active NPI

Paula Kay Sheedy, D.C.

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1205974904
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AO5346 Issued in IA
Practice address
3515 Spring St
Suite #3
Davenport, IA 52807-2100
Phone
(563) 359-6400
Fax
(563) 359-3543
NPI assigned
Feb 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X AO5346 IA Primary

Addresses

Primary practice location

3515 Spring St
Suite #3
Davenport, IA 52807-2100

Mailing address

1122 W 51St St
Davenport, IA 52806-3703
Phone (563) 359-6400

Other identifiers 2

IdentifierTypeStateIssuer
0051102MedicaidIA
27140OtherIAWELLMARK BLUE CROSS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118000291 IA Practitioner - Chiropractic 3779532700 Practice locations: Davenport, IA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3515 Spring St
Davenport, IA 52807-2100
Phone (563) 359-6400

3515 Spring St. 6
Davenport, IA 52807-2100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AO5346IAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1170374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205974904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1122 W 51ST ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528063703",
            "telephone_number": "563-359-6400",
            "fax_number": "563-359-3543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3515 SPRING ST",
            "address_2": "SUITE #3",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072100",
            "telephone_number": "563-359-6400",
            "fax_number": "563-359-3543"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEEDY",
        "first_name": "PAULA",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "AO5346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0051102",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BLUE CROSS",
            "identifier": "27140",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.