NPIMap

Organization Active NPI

Clinton Back & Neck Care Center

  • Chiropractor
  • Clinton, IA
National Provider Identifier
1336196195
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
03059 Issued in IA
Legal business name
CLINTON BACK & NECK CARE CENTER
Practice address
242 N Bluff Blvd
Suite 201
Clinton, IA 52732-7119
Phone
(563) 242-5375
Fax
(563) 242-5264
NPI assigned
May 27, 2006
Last updated
Dec 10, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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

Authorized official

Name
Dr. Pamela Ann Lerouxtroxell, DCNPI 1477510451
Title
Clinic Director
Phone
(563) 242-5375

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
Chiropractor 111N00000X 03059 IA Primary

Addresses

Primary practice location

242 N Bluff Blvd
Suite 201
Clinton, IA 52732-7119

Mailing address

242 N Bluff Blvd
Suite 201
Clinton, IA 52732-7119
Phone (563) 242-5375

Other identifiers 3

IdentifierTypeStateIssuer
0173070MedicaidIA
44968OtherIAWELLMARK
CI2542OtherIARAILROAD MEDICARE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197244800000",
    "number": "1336196195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "242 N BLUFF BLVD",
            "address_2": "SUITE 201",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527327119",
            "telephone_number": "563-242-5375",
            "fax_number": "563-242-5264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "242 N BLUFF BLVD",
            "address_2": "SUITE 201",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527327119",
            "telephone_number": "563-242-5375",
            "fax_number": "563-242-5264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINTON BACK & NECK CARE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-12-10",
        "status": "A",
        "authorized_official_last_name": "LEROUXTROXELL",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "563-242-5375",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "03059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0173070",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "44968",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CI2542",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.