Organization Active NPI

Calisesi Chiropractic Clinic, PLLC

  • Chiropractor
  • Fort Dodge, IA
National Provider Identifier
1255738266
Registry record updated Nov 20, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CALISESI CHIROPRACTIC CLINIC, PLLC
Practice address
24 S 14TH St
Fort Dodge, IA 50501-4964
Phone
(515) 576-2183
NPI assigned
Nov 20, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2014

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

Authorized official

Name
Dr. Brady S PearsonNPI 1093013898
Title
President
Phone
(515) 576-2183

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

24 S 14TH St
Fort Dodge, IA 50501-4964

Mailing address

24 S 14TH St
Fort Dodge, IA 50501-4964

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141219001563 IA Part B Supplier - Clinic/Group Practice 0648593889 Receives reassigned benefits from 3 practitioners
Practice locations: Fort Dodge, IA

National Provider Directory

National Provider Directory

Locations

24 S 14th St
Fort Dodge, IA 50501
Phone (515) 576-2183

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1416441600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1416441600000",
    "number": "1255738266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 S 14TH ST",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 S 14TH ST",
            "city": "FORT DODGE",
            "state": "IA",
            "postal_code": "505014964",
            "telephone_number": "515-576-2183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALISESI CHIROPRACTIC CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-11-20",
        "last_updated": "2014-11-20",
        "status": "A",
        "authorized_official_last_name": "PEARSON",
        "authorized_official_first_name": "BRADY",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-576-2183",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Dodge, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2014; 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.