Organization Active NPI

Koenen & Collins Chiropractic Clinic

  • Chiropractor
  • Hampton, IA
National Provider Identifier
1366413676
Registry record updated Oct 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05494 Issued in IA
Legal business name
KOENEN & COLLINS CHIROPRACTIC CLINIC
Practice address
303 Central Ave E
Hampton, IA 50441-2025
Phone
(641) 456-4142
Fax
(641) 456-2777
NPI assigned
Jan 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 17, 2007

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

Authorized official

Name
Dr. James Richard Koenen, DCNPI 1972583557
Title
Doctor/Partner
Phone
(641) 456-4142

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X A05485 IA
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X A05494 IA Primary

Addresses

Primary practice location

303 Central Ave E
Hampton, IA 50441-2025

Mailing address

303 Central Ave E
Hampton, IA 50441-2025
Phone (641) 456-4142

Other identifiers 1

IdentifierTypeStateIssuer
0002444MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040305001019 IA Part B Supplier - Clinic/Group Practice 3375431901 Receives reassigned benefits from 2 practitioners
Practice locations: Hampton, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D2331703Koenen and Collins Chiropractic Clinic303 Central Ave E, Hampton, IA 50441Certificate of waiverOct 6, 2027

National Provider Directory

National Provider Directory

Locations

303 Central Ave E
Hampton, IA 50441
Phone (515) 456-4142

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": "1138320000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192579200000",
    "number": "1366413676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "303 CENTRAL AVE E",
            "city": "HAMPTON",
            "state": "IA",
            "postal_code": "504412025",
            "telephone_number": "641-456-4142",
            "fax_number": "641-456-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 CENTRAL AVE E",
            "city": "HAMPTON",
            "state": "IA",
            "postal_code": "504412025",
            "telephone_number": "641-456-4142",
            "fax_number": "641-456-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KOENEN & COLLINS CHIROPRACTIC CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-27",
        "last_updated": "2007-10-17",
        "status": "A",
        "authorized_official_last_name": "KOENEN",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "DOCTOR/PARTNER",
        "authorized_official_telephone_number": "641-456-4142",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05485",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0002444",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 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.