Organization Active NPI

Orange City Chiropractic Center P.C.

  • Chiropractor
  • Orange City, IA
National Provider Identifier
1295917896
Registry record updated Dec 5, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A06091 Issued in IA
Legal business name
ORANGE CITY CHIROPRACTIC CENTER P.C.
Practice address
123 Albany Ave SE
Orange City, IA 51041-1715
Phone
(712) 737-3339
Fax
(712) 737-3339
NPI assigned
Dec 5, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2007

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

Authorized official

Name
Trent P. Abrahamson, D.C.NPI 1558301630
Title
Owner
Phone
(712) 737-3339

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 A06091 IA Primary

Addresses

Primary practice location

123 Albany Ave SE
Orange City, IA 51041-1715

Mailing address

123 Albany Ave SE
Orange City, IA 51041-1715
Phone (712) 737-3339

Other identifiers 1

IdentifierTypeStateIssuer
I15033OtherIAMEDICARE GROUP NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050429000947 IA Part B Supplier - Clinic/Group Practice 3870532617 Receives reassigned benefits from 1 practitioner
Practice locations: Orange City, IA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1196812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196812800000",
    "number": "1295917896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 ALBANY AVE SE",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411715",
            "telephone_number": "712-737-3339",
            "fax_number": "712-737-3339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "123 ALBANY AVE SE",
            "city": "ORANGE CITY",
            "state": "IA",
            "postal_code": "510411715",
            "telephone_number": "712-737-3339",
            "fax_number": "712-737-3339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORANGE CITY CHIROPRACTIC CENTER P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-05",
        "last_updated": "2007-12-05",
        "status": "A",
        "authorized_official_last_name": "ABRAHAMSON",
        "authorized_official_first_name": "TRENT",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-737-3339",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A06091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "I15033",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orange City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2007; 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.