Organization Active NPI

Waterloo Chiropractic Center PLLC

  • Chiropractor
  • Waterloo, IA
National Provider Identifier
1225669302
Registry record updated Jul 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WATERLOO CHIROPRACTIC CENTER PLLC
Practice address
3731 Kimball Ave
Waterloo, IA 50702-5728
Phone
(319) 232-1143
Fax
(319) 232-3279
NPI assigned
Jan 28, 2020
Last updated
Jul 9, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2020

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

Authorized official

Name
Dr. Jeffrey James Meyer, DCNPI 1417976374
Title
Owner
Phone
(319) 310-7245

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3731 Kimball Ave
Waterloo, IA 50702-5728

Mailing address

3731 Kimball Ave
Waterloo, IA 50702-5728
Phone (319) 232-1143

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200702000759 IA Part B Supplier - Clinic/Group Practice 6608299052 Receives reassigned benefits from 6 practitioners
Practice locations: Waterloo, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1580169600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594252800000",
    "number": "1225669302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3731 KIMBALL AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025728",
            "telephone_number": "319-232-1143",
            "fax_number": "319-232-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3731 KIMBALL AVE",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507025728",
            "telephone_number": "319-232-1143",
            "fax_number": "319-232-3279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERLOO CHIROPRACTIC CENTER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-28",
        "last_updated": "2020-07-09",
        "certification_date": "2020-07-09",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-310-7245",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2020; 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.