Daniel R Blohm, DC
Individual provider Active NPI Chiropractor · Clinton, IA
NPI 1245200799 · NPPES record last updated Sep 8, 2011
Key facts
- NPI
- 1245200799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- A05764 (IA)
- Practice address
- 326 3Rd Ave S
Clinton, IA 52732-4436 - Phone
- (563) 242-9122
- NPI assigned
- Jan 26, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Stumbaugh Inc
Practice addresses (Care Compare)
1300 Sunset Dr
Norwalk, IA 50211-1344
Phone (515) 981-9208
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120209000463 | IA | Practitioner - Chiropractic | 0143487728 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A05764 | IA | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Stumbaugh Inc | Chiropractor | Current |
Accepting new patients |
| Bart W Leavens PC | Current |
Accepting new patients |
Locations
326 3rd Ave S
Clinton, IA 52732
Phone (563) 241-4295
1300 Sunset Dr
Norwalk, IA 50211
Phone (515) 981-9208
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | A05764 | IA | Yes |
Addresses
Primary practice location
326 3Rd Ave S
Clinton, IA 52732-4436
Mailing address
326 3Rd Ave S
Clinton, IA 52732-4436
Phone (563) 242-9122
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9990 | Other | MIDLAND CHOICE | |
| 15003 | Other | BLUECARD | |
| 2109264 | Medicaid | IA | |
| 5521461 | Other | AETNA |
Other providers in Clinton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 8, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.