NPIMap

Organization Active NPI

Elite Chiropractic & Tissue Rehabilitation, LLC

  • Clinic/Center
  • Kearney, NE
National Provider Identifier
1295036630
Registry record updated Jan 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
39 Issued in NE
Legal business name
ELITE CHIROPRACTIC & TISSUE REHABILITATION, LLC
Practice address
8 W 56TH St
Suite A1 East
Kearney, NE 68847-0505
Phone
(308) 455-1500
Fax
(308) 455-1502
NPI assigned
Nov 16, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2016

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

Authorized official

Name
Cory J Stickney, D.C.NPI 1295035814
Title
Manager
Phone
(308) 455-1500

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
Clinic/Center 261Q00000X 39 NE Primary

Addresses

Primary practice location

8 W 56TH St
Suite A1 East
Kearney, NE 68847-0505

Mailing address

8 W 56TH St
Suite A1 East
Kearney, NE 68847-0505
Phone (308) 455-1500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110210000461 NE Part B Supplier - Clinic/Group Practice 2961682794 Receives reassigned benefits from 7 practitioners
Practice locations: Kearney, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1289865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453939200000",
    "number": "1295036630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 W 56TH ST",
            "address_2": "SUITE A1 EAST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688470505",
            "telephone_number": "308-455-1500",
            "fax_number": "308-455-1502"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8 W 56TH ST",
            "address_2": "SUITE A1 EAST",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688470505",
            "telephone_number": "308-455-1500",
            "fax_number": "308-455-1502"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CHIROPRACTIC & TISSUE REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-16",
        "last_updated": "2016-01-28",
        "status": "A",
        "authorized_official_last_name": "STICKNEY",
        "authorized_official_first_name": "CORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "308-455-1500",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NE",
            "license": "39",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2016; 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.