Individual provider Active NPI

Mark A Reetz, D.C.

  • Chiropractor
  • Manchester, IA
National Provider Identifier
1386680833
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05878 Issued in IA
Practice address
115 W Main St
Manchester, IA 52057-1535
Phone
(563) 927-2961
Fax
(563) 927-3846
NPI assigned
Jun 22, 2006
Last updated
Jul 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05878 IA Primary

Addresses

Primary practice location

115 W Main St
Manchester, IA 52057-1535

Mailing address

115 W Main St
Manchester, IA 52057-1535
Phone (563) 927-2961

Other identifiers 2

IdentifierTypeStateIssuer
0160945MedicaidIA
40039OtherIABLUE SHIELD OF IOWA CHIRO

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100823000053 IA Practitioner - Chiropractic 3779617097 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

115 W Main St
Manchester, IA 52057-1535
Phone (563) 927-2961

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A05878IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Reetz Chiropractic Clinic, PC Chiropractor CurrentSince Jul 1, 2014 Accepting new patients
Reetz Chiropractic Clinic Chiropractor PastSince Jul 1, 2012 Accepting new patients
Dunn Chiropractic Clinic Chiropractor Past Accepting new patients

Locations

115 W Main St
Manchester, IA 52057
Phone (319) 927-2961

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1386680833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571535",
            "telephone_number": "563-927-2961",
            "fax_number": "563-927-3846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 W MAIN ST",
            "city": "MANCHESTER",
            "state": "IA",
            "postal_code": "520571535",
            "telephone_number": "563-927-2961",
            "fax_number": "563-927-3846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REETZ",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05878",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0160945",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF IOWA CHIRO",
            "identifier": "40039",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.