Individual provider Active NPI

Jeremiah Jon Rethwisch, DC

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1447264254
Registry record updated Mar 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1367 Issued in NE
Practice address
18010 R PLZ
Ste 104
Omaha, NE 68135
Phone
(402) 980-6561
Fax
(402) 408-6620
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1367 NE Primary

Addresses

Primary practice location

18010 R PLZ
Ste 104
Omaha, NE 68135

Mailing address

18010 R PLZ
Ste 104
Omaha, NE 68135
Phone (402) 980-6991

Other identifiers 2

IdentifierTypeStateIssuer
09583OtherBLUE CROSS BLUE SHIELD
P00207772OtherNERAILROAD MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050317000346 NE Practitioner - Chiropractic 0143275727 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rethwisch Family Chiropractic, P.C.Group PAC ID 5799730370, 3 clinicians

Practice addresses (Care Compare)

18010 R PLZ
Suite 104
Omaha, NE 68135-1923
Phone (402) 408-6561

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1367NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rethwisch Family Chiropractic, P.C. Chiropractor CurrentSince Mar 1, 2005 Accepting new patients
Docjjr, LLC Chiropractor CurrentSince Mar 1, 2016 Accepting new patients

Locations

11917 Pierce Plz
Omaha, NE 68144
Phone (402) 778-1100

18010 R Plz
Ste 104
Omaha, NE 68135
Phone (402) 408-6561

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395705600000",
    "number": "1447264254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18010 R PLZ",
            "address_2": "STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68135",
            "telephone_number": "402-980-6991",
            "fax_number": "402-408-6620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18010 R PLZ",
            "address_2": "STE 104",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "68135",
            "telephone_number": "402-980-6561",
            "fax_number": "402-408-6620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RETHWISCH",
        "first_name": "JEREMIAH",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2014-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1367",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09583",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00207772",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2014; 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.

Verify at the official NPI Registry.