NPIMap

Organization Active NPI

Niemeier Spine & Sports Chiropractic PLC

  • Chiropractor
  • Lake Park, IA
National Provider Identifier
1407030422
Registry record updated May 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06762 Issued in IA
Legal business name
NIEMEIER SPINE & SPORTS CHIROPRACTIC PLC
Practice address
222 Market Street
Lake Park, IA 51347-0246
Phone
(712) 832-3056
Fax
(712) 832-3360
NPI assigned
Dec 27, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2013

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

Authorized official

Name
Dr. Chad Michael Niemeier, D.C.NPI 1083700579
Title
Owner
Phone
(712) 832-3056

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 06762 IA Primary

Addresses

Primary practice location

222 Market Street
Lake Park, IA 51347-0246

Mailing address

PO Box 246
222 Market Street
Lake Park, IA 51347-0246
Phone (712) 832-3056

Other identifiers 1

IdentifierTypeStateIssuer
1454371MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050823001177 IA Part B Supplier - Clinic/Group Practice 9436180049 Receives reassigned benefits from 2 practitioners
Practice locations: Lake Park, IA

National Provider Directory

National Provider Directory

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": "1198713600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1368576000000",
    "number": "1407030422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 246",
            "address_2": "222 MARKET STREET",
            "city": "LAKE PARK",
            "state": "IA",
            "postal_code": "513470246",
            "telephone_number": "712-832-3056",
            "fax_number": "712-832-3360"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 MARKET STREET",
            "city": "LAKE PARK",
            "state": "IA",
            "postal_code": "513470246",
            "telephone_number": "712-832-3056",
            "fax_number": "712-832-3360"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NIEMEIER SPINE & SPORTS CHIROPRACTIC PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-27",
        "last_updated": "2013-05-15",
        "status": "A",
        "authorized_official_last_name": "NIEMEIER",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-832-3056",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1454371",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Park, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2013; 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.