Individual provider Active NPI

Nichole Danielle Gevock, D.C.

  • Chiropractor
  • Ottumwa, IA
National Provider Identifier
1306389382
Registry record updated May 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
084409 Issued in IA
Practice address
119 W 2ND St
Ottumwa, IA 52501-2502
Phone
(641) 954-8598
NPI assigned
Nov 23, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 084409 IA Primary

Addresses

Primary practice location

119 W 2ND St
Ottumwa, IA 52501-2502

Mailing address

119 W 2ND St
Ottumwa, IA 52501-2502
Phone (641) 954-8598

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161205000455 IA Practitioner - Chiropractic 4284914540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 W 2ND St
Ottumwa, IA 52501-2502
Phone (641) 954-8598

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Family First Chiropractic Clinic PLLC Chiropractor CurrentSince Apr 3, 2017 Accepting new patients

Locations

119 W 2nd St
Ottumwa, IA 52501
Phone (641) 919-7691

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1479859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494547200000",
    "number": "1306389382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 W 2ND ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012502",
            "telephone_number": "641-954-8598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 W 2ND ST",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525012502",
            "telephone_number": "641-954-8598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GEVOCK",
        "first_name": "NICHOLE",
        "middle_name": "DANIELLE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-11-23",
        "last_updated": "2017-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "084409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.