Organization Active NPI

Redenbaugh Chiropractic PC

  • Chiropractor
  • Storm Lake, IA
National Provider Identifier
1356508394
Registry record updated May 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A06093 Issued in IA
Legal business name
REDENBAUGH CHIROPRACTIC PC
Practice address
800 Oneida St
Suite B
Storm Lake, IA 50588-3209
Phone
(712) 732-3349
NPI assigned
May 19, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 19, 2008

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

Authorized official

Name
Tim J Redenbaugh
Title
Owner
Phone
(712) 732-3349

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X A06093 IA Primary

Addresses

Primary practice location

800 Oneida St
Suite B
Storm Lake, IA 50588-3209

Mailing address

800 Oneida St
Suite B
Storm Lake, IA 50588-3209
Phone (712) 732-3349

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080519000781 IA Part B Supplier - Clinic/Group Practice 3173692910 Receives reassigned benefits from 1 practitioner
Practice locations: Storm Lake, IA

National Provider Directory

National Provider Directory

Locations

800 Oneida St
Ste B
Storm Lake, IA 50588
Phone (712) 732-3349

Practitioners & affiliated clinicians

Practitioners 4

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": "1211155200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211155200000",
    "number": "1356508394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 ONEIDA ST",
            "address_2": "SUITE B",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505883209",
            "telephone_number": "712-732-3349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ONEIDA ST",
            "address_2": "SUITE B",
            "city": "STORM LAKE",
            "state": "IA",
            "postal_code": "505883209",
            "telephone_number": "712-732-3349"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDENBAUGH CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-19",
        "last_updated": "2008-05-19",
        "status": "A",
        "authorized_official_last_name": "REDENBAUGH",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-732-3349"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A06093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Storm Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; 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.