Active NPI
Advanced Spine and Rehab Center PC
- Family Medicine Physician
- Cedar Rapids, IA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- Legal business name
- ADVANCED SPINE AND REHAB CENTER PC
- Practice address
- 4205 Glass Rd NE
Cedar Rapids, IA 52402-2514 - Phone
- (319) 294-0094
- Fax
- (319) 294-0095
- NPI assigned
- Feb 12, 2007
- Last updated
- Feb 2, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Jeffrey Alan Mitchell, D.C.
- Title
- President
- Phone
- (319) 981-2292
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 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 6916 | IA | |
| Family Medicine Physician | 207Q00000X | Primary | ||
| Internal Medicine Physician | 207R00000X | 27216 | IA | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | IA | ||
| Nurse Practitioner | 363L00000X | 110073 | IA |
Addresses
Primary practice location
4205 Glass Rd NE
Cedar Rapids, IA 52402-2514
Mailing address
4205 Glass Rd NE
Cedar Rapids, IA 52402-2514
Phone (319) 294-0094
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 2
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2022914 | Advanced Spine & Rehab Center, PC Laboratory | Certificate of waiver | Apr 11, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Cedar Rapids Pain Associates PC | Traction Equipment|(TENS) Transcutaneous Electrical Nerve Stimulators and/or Supplies|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf | Accepts assignment |
National Provider Directory
National Provider DirectoryLocations
1110 Old Marion Rd NE
Ste 2
Cedar Rapids, IA 52402
Phone (319) 378-8046
4205 Glass Rd NE
Ste 524
Cedar Rapids, IA 52402
Interoperability endpoints
- https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72613
Practitioners & affiliated clinicians
Practitioners 9
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.
-
- Chiropractor
- Cedar Rapids, IA
- NPI 1306873328
-
- Acute Care Nurse Practitioner
- Cedar Rapids, IA
- NPI 1306210729
-
- Nurse Practitioner
- Cedar Rapids, IA
- NPI 1679240972
-
- Pain Medicine Physician
- Davenport, IA
- NPI 1265439947
-
- Chiropractor
- Williamsburg, IA
- NPI 1821862079
-
- Physical Therapist
- Amana, IA
- NPI 1720149149
-
- Physical Therapist
- Vinton, IA
- NPI 1982448205
-
- Nurse Practitioner
- Cedar Rapids, IA
- NPI 1245584564
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1454371200000",
"number": "1386785293",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4205 GLASS RD NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524022514",
"telephone_number": "319-294-0094",
"fax_number": "319-294-0095"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4205 GLASS RD NE",
"city": "CEDAR RAPIDS",
"state": "IA",
"postal_code": "524022514",
"telephone_number": "319-294-0094",
"fax_number": "319-294-0095"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ADVANCED SPINE AND REHAB CENTER PC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-12",
"last_updated": "2016-02-02",
"status": "A",
"authorized_official_last_name": "MITCHELL",
"authorized_official_first_name": "JEFFREY",
"authorized_official_middle_name": "ALAN",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "319-981-2292",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "D.C."
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Chiropractor",
"state": "IA",
"license": "6916",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Family Medicine",
"state": null,
"license": null,
"primary": true
},
{
"code": "207R00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine",
"state": "IA",
"license": "27216",
"primary": false
},
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "IA",
"license": null,
"primary": false
},
{
"code": "363L00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Nurse Practitioner",
"state": "IA",
"license": "110073",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cedar Rapids, IA
- Barth David Adolphson, D.C.
- Rebekah Ann Adolphson, LMSW
- Adrian P Rehak, DDS, PC
- Advanced Center for Electrolysis & Laser, LLC (Advanced Center for Electrolysis, Laser & Skin)
- Advanced Dental Care, PC
- Advantage Chiropractic, PLLC
- Affiliates of Family Practice of Cedar Rapids (Affiliates of Family Practice)
- Affordable Dentures - Cedar Rapids, P.C.
- Affordable Dentures & Implants - Cedar Rapids III, P.C.
- Affordable Dentures & Implants - Cedar Rapids IV, P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.