NPIMap

Organization Active NPI

Grand Island Chiropractic Center, PC

  • Chiropractor
  • Grand Island, NE
National Provider Identifier
1427262633
Registry record updated May 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
638 Issued in NE
Legal business name
GRAND ISLAND CHIROPRACTIC CENTER, PC
Practice address
620 N Custer Ave
Grand Island, NE 68803-4375
Phone
(308) 381-1312
NPI assigned
May 9, 2007
Last updated
May 15, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2008

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

Authorized official

Name
Dr. Timothy L Dunagan, D.C.NPI 1336128974
Title
Owner
Phone
(308) 381-1312

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 638 NE Primary

Addresses

Primary practice location

620 N Custer Ave
Grand Island, NE 68803-4375

Mailing address

620 N Custer Ave
Grand Island, NE 68803-4375
Phone (308) 381-1312

Other identifiers 1

IdentifierTypeStateIssuer
009513OtherNEBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070926000130 NE Part B Supplier - Clinic/Group Practice 3173617537 Receives reassigned benefits from 3 practitioners
Practice locations: Grand Island, NE

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210809600000",
    "number": "1427262633",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 N CUSTER AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034375",
            "telephone_number": "308-381-1312"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 N CUSTER AVE",
            "city": "GRAND ISLAND",
            "state": "NE",
            "postal_code": "688034375",
            "telephone_number": "308-381-1312"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRAND ISLAND CHIROPRACTIC CENTER, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2008-05-15",
        "status": "A",
        "authorized_official_last_name": "DUNAGAN",
        "authorized_official_first_name": "TIMOTHY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "308-381-1312",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "638",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "009513",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Island, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; 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.