Organization Active NPI

Renew Chiropractic LLC

  • Chiropractor
  • Muscatine, IA
National Provider Identifier
1316657398
Registry record updated Feb 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
RENEW CHIROPRACTIC LLC
Practice address
201 E 2ND St
Muscatine, IA 52761-4006
Phone
(563) 506-3706
NPI assigned
Nov 30, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 2, 2023

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

Authorized official

Name
Josiah Street, DCNPI 1356724363
Title
Manager
Phone
(563) 261-7502

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

201 E 2ND St
Muscatine, IA 52761-4006

Mailing address

201 E 2ND St
Muscatine, IA 52761-4006
Phone (563) 506-3706

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230103000151 IA Part B Supplier - Clinic/Group Practice 5092185389 Receives reassigned benefits from 2 practitioners
Practice locations: Muscatine, IA

National Provider Directory

National Provider Directory

Locations

1600 Plaza Pl
Muscatine, IA 52761

201 E 2nd St
Muscatine, IA 52761
Phone (563) 299-1380

Practitioners & affiliated clinicians

Practitioners 2

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": "1669766400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1316657398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 E 2ND ST",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527614006",
            "telephone_number": "563-506-3706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 E 2ND ST",
            "city": "MUSCATINE",
            "state": "IA",
            "postal_code": "527614006",
            "telephone_number": "563-506-3706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENEW CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-30",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "STREET",
        "authorized_official_first_name": "JOSIAH",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "563-261-7502",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muscatine, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; 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.