Individual provider Active NPI

Elizabeth Huntington Mathis Huebl, D.C.

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1386940963
Registry record updated Mar 14, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
4727-012 Issued in WI
Practice address
1136 E Rusholme St
Davenport, IA 52803-2517
Phone
(563) 650-9882
NPI assigned
Jan 31, 2011
Last updated
Mar 14, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 4727-012 WI Primary

Addresses

Primary practice location

1136 E Rusholme St
Davenport, IA 52803-2517

Mailing address

1136 E Rusholme St
Davenport, IA 52803-2517
Phone (563) 650-9882

Other identifiers 1

IdentifierTypeStateIssuer
38995100MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4727-012WIMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Breidenbach Family and Sports Chiropractic Inc Chiropractor PastSince Jan 1, 2003 Accepting new patients
Black River Chiropractic Center, SC Chiropractor Past Accepting new patients
Davis Chiropractic SC Chiropractor PastSince Sep 14, 2005 Accepting new patients
Back to Health Chiropractic LLC Chiropractor Past Accepting new patients

Organizations & group practices 4

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": "1296432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331683200000",
    "number": "1386940963",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1136 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032517",
            "telephone_number": "563-650-9882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 E RUSHOLME ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528032517",
            "telephone_number": "563-650-9882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUEBL",
        "first_name": "ELIZABETH",
        "middle_name": "HUNTINGTON MATHIS",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-31",
        "last_updated": "2012-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WI",
            "license": "4727-012",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "38995100",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.