Heartland Family Health & Chiropractic Clinic, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

1023 Issued in NE

Legal business name

HEARTLAND FAMILY HEALTH & CHIROPRACTIC CLINIC, INC.

Practice address

1715 N Bell St
Optional
Fremont, NE 68025-3158

Phone

(402) 721-1060

Fax

(402) 727-4761

NPI assigned

Mar 9, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Randy J Camenzind, D.C.NPI 1245246859

Title

President

Phone

(402) 721-1060

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• Heartland Chiropractic Clinic Other name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NE

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Randy J Camenzind, DC

  • Chiropractor
  • Fremont, NE
  • NPI 1245246859
  Medicare reassignment Care Compare group NPD Authorized official
• Marylou Camenzind, DC

  • Chiropractor
  • Fremont, NE
  • NPI 1043234420
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1606262400000",
    "number": "1356472286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1861 E 23RD ST",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680252437",
            "telephone_number": "402-721-1060",
            "fax_number": "402-727-4761"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 N BELL ST",
            "address_2": "OPTIONAL",
            "city": "FREMONT",
            "state": "NE",
            "postal_code": "680253158",
            "telephone_number": "402-721-1060",
            "fax_number": "402-727-4761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEARTLAND FAMILY HEALTH & CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-09",
        "last_updated": "2020-11-25",
        "certification_date": "2020-11-24",
        "status": "A",
        "authorized_official_last_name": "CAMENZIND",
        "authorized_official_first_name": "RANDY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-721-1060",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1023",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1063",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "36613",
            "state": "NE"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "=========",
            "state": "NE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "36612",
            "state": "NE"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hccdrrdrm@qwestoffice.net",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Email",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Email",
            "address_1": "1715 N Bell St",
            "address_2": "Optional",
            "city": "Fremont",
            "state": "NE",
            "country_code": "US",
            "postal_code": "680253158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Heartland Chiropractic Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Heartland Chiropractic Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Chiropractor in Fremont, NE
• Providers in Fremont, NE by specialty
• Chiropractor in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2020; 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.