Organization Active NPI

Rock Valley Chiropractic, LLC

  • Chiropractor
  • Rock Valley, IA
National Provider Identifier
1407271208
Registry record updated Mar 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007159 Issued in IA
Legal business name
ROCK VALLEY CHIROPRACTIC, LLC
Practice address
1315 Golf Course Rd
Rock Valley, IA 51247-1548
Phone
(712) 476-2841
Fax
(712) 476-5085
NPI assigned
Mar 3, 2014
Last updated
Mar 3, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2014

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

Authorized official

Name
Dr. Jacob Paul Brosamle, D.C.NPI 1235377938
Title
Owner
Phone
(712) 476-2841

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
Chiropractor 111N00000X 007159 IA Primary

Addresses

Primary practice location

1315 Golf Course Rd
Rock Valley, IA 51247-1548

Mailing address

1315 Golf Course Rd
Rock Valley, IA 51247-1548
Phone (712) 476-2841

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140417000839 IA Part B Supplier - Clinic/Group Practice 4587896949 Receives reassigned benefits from 1 practitioner
Practice locations: Rock Valley, IA

National Provider Directory

National Provider Directory

Locations

1315 Golf Course Rd
Rock Valley, IA 51247
Phone (712) 476-2841

Practitioners & affiliated clinicians

Practitioners 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1393804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1393804800000",
    "number": "1407271208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 GOLF COURSE RD",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512471548",
            "telephone_number": "712-476-2841",
            "fax_number": "712-476-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 GOLF COURSE RD",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512471548",
            "telephone_number": "712-476-2841",
            "fax_number": "712-476-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROCK VALLEY CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-03",
        "last_updated": "2014-03-03",
        "status": "A",
        "authorized_official_last_name": "BROSAMLE",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "712-476-2841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Valley, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2014; 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.