Individual provider Active NPI

Dalton Daniel Doudna, DC

  • Chiropractor
  • Davenport, IA
National Provider Identifier
1457826497
Registry record updated Oct 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
086349 Issued in IA
Practice address
3536 Jersey Ridge Rd
Davenport, IA 52807-2223
Phone
(740) 260-1635
NPI assigned
Oct 5, 2018
Last updated
Oct 5, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 086349 IA Primary

Addresses

Primary practice location

3536 Jersey Ridge Rd
Davenport, IA 52807-2223

Mailing address

2121 W 18TH St
Davenport, IA 52804-3523
Phone (740) 260-1635

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201119001785 OH Practitioner - Chiropractic 3173934304 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2017
Medicare assignment
May accept Medicare assignment
Group practices
Doudna Chiropractic, LLCGroup PAC ID 8921181686, 2 clinicians

Practice addresses (Care Compare)

400 N St
Suite 1
Caldwell, OH 43724
Phone (740) 732-4242

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
086349IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Doudna Chiropractic, LLC Chiropractor CurrentSince Aug 18, 2020 Accepting new patients

Locations

400 North St
#1
Caldwell, OH 43724
Phone (614) 732-4242

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, 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": "1538697600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538697600000",
    "number": "1457826497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 W 18TH ST",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528043523",
            "telephone_number": "740-260-1635"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3536 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072223",
            "telephone_number": "740-260-1635"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUDNA",
        "first_name": "DALTON",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-10-05",
        "last_updated": "2018-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "086349",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 5, 2018; 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.