Prairieland Chiropractic P C

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

A05231 Issued in IA

Legal business name

PRAIRIELAND CHIROPRACTIC P C

Practice address

133 W Main Ave
Rockford, IA 50468-7719

Phone

(641) 756-3653

Fax

(641) 756-3722

NPI assigned

Sep 19, 2012

Last updated

Sep 19, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeanne Renee Staudt, D.C.NPI 1821039942

Title

President/Owner

Phone

(641) 756-3740

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Practitioners 1

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.

• Jeanne Renee Staudt, D.C.

  • Chiropractor
  • Rockford, IA
  • NPI 1821039942
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1348012800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348012800000",
    "number": "1235489048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W MAIN AVE",
            "address_2": "P.O. BOX 575",
            "city": "ROCKFORD",
            "state": "IA",
            "postal_code": "504687719",
            "telephone_number": "641-756-3653",
            "fax_number": "641-756-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W MAIN AVE",
            "city": "ROCKFORD",
            "state": "IA",
            "postal_code": "504687719",
            "telephone_number": "641-756-3653",
            "fax_number": "641-756-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIELAND CHIROPRACTIC P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-19",
        "last_updated": "2012-09-19",
        "status": "A",
        "authorized_official_last_name": "STAUDT",
        "authorized_official_first_name": "JEANNE",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "641-756-3740",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "41891",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1242305",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "41891",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA PROV. NUMBER",
            "identifier": "P00070391",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa A Kapler, MD
• Kimberly Ann Kuehner, ARNP
• Sierra Kuhlers
• Michael C Lindstrom, DO
• North Iowa Mercy Clinics (Mercy Family Clinic-Rockford)
• Rudd Rockford Marble Rock
• Mary Ann Shaw, ARNP
• Jeanne Renee Staudt, D.C.
• Sabrina Staudt

• Chiropractor in Rockford, IA
• Providers in Rockford, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.