Organization Active NPI

Advanced Chiropractic & Neurology, PC

  • Neurology Chiropractor
  • La Vista, NE
National Provider Identifier
1467603464
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology ChiropractorTaxonomy code 111NN0400X
Legal business name
ADVANCED CHIROPRACTIC & NEUROLOGY, PC
Practice address
12040 McDermott PLZ
Ste 320
La Vista, NE 68128-2354
Phone
(402) 597-2869
Fax
(402) 597-2536
NPI assigned
Oct 8, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Authorized official

Name
Dr. John W McClaren, D.C., DACNBNPI 1104046945
Title
President
Phone
(402) 597-2869

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
Neurology ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NN0400X Primary

Addresses

Primary practice location

12040 McDermott PLZ
Ste 320
La Vista, NE 68128-2354

Mailing address

12040 McDermott PLZ
Ste 320
La Vista, NE 68128-2354
Phone (402) 597-2869

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090108000403 NE Part B Supplier - Clinic/Group Practice 6507929130 Receives reassigned benefits from 1 practitioner
Practice locations: La Vista, NE

National Provider Directory

National Provider Directory

Locations

8825 S 117th St
La Vista, NE 68128
Phone (402) 597-2869

12040 McDermott Plz
Ste 320
Lavista, NE 68128
Phone (402) 597-2869

Practitioners & affiliated clinicians

Practitioners 3

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": "1223424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1467603464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12040 MCDERMOTT PLZ",
            "address_2": "STE 320",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681282354",
            "telephone_number": "402-597-2869",
            "fax_number": "402-597-2536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12040 MCDERMOTT PLZ",
            "address_2": "STE 320",
            "city": "LA VISTA",
            "state": "NE",
            "postal_code": "681282354",
            "telephone_number": "402-597-2869",
            "fax_number": "402-597-2536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED CHIROPRACTIC & NEUROLOGY, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-08",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "MCCLAREN",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-597-2869",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C., DACNB"
    },
    "taxonomies": [
        {
            "code": "111NN0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Vista, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.