Individual provider Active NPI

Russell Wayne Corey, D.C.

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1306959663
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1201 Issued in NE
Practice address
3714 S 132ND St
Omaha, NE 68144-3608
Phone
(402) 891-6289
NPI assigned
Aug 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1201 NE Primary

Addresses

Primary practice location

3714 S 132ND St
Omaha, NE 68144-3608

Mailing address

3714 S 132ND St
Omaha, NE 68144-3608
Phone (402) 891-6289

Other identifiers 1

IdentifierTypeStateIssuer
470825186-00MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000012 NE Practitioner - Chiropractic 9830232818 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Russ Corey Chiropractic PCGroup PAC ID 4284777269, 2 clinicians

Practice addresses (Care Compare)

2705 S 148TH St
Suite a
Omaha, NE 68144-3226
Phone (402) 334-1114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Russ Corey Chiropractic PC CurrentSince Oct 18, 1999 Accepting new patients
Diamond Chiropractic & Acupuncture, LLC Chiropractor Past Accepting new patients
Russ Corey Chiropractic PC Chiropractor PastSince Oct 18, 1999 Accepting new patients

Locations

3714 S 132nd St
Omaha, NE 68144
Phone (402) 334-1114

2705 S 148th St
Omaha, NE 68144
Phone (402) 334-1114

2705 S 148th St
Ste A
Omaha, NE 68144
Phone (402) 334-1114

Organizations & group practices 3

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306959663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 S 132ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443608",
            "telephone_number": "402-891-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3714 S 132ND ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681443608",
            "telephone_number": "402-891-6289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COREY",
        "first_name": "RUSSELL",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "470825186-00",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.