Organization Active NPI

Prairielands Chiropractic Clinic P.C.

  • Chiropractor
  • Council Bluffs, IA
National Provider Identifier
1477837615
Registry record updated Oct 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007034 Issued in IA
Legal business name
PRAIRIELANDS CHIROPRACTIC CLINIC P.C.
Practice address
300 W Broadway
Suite 712
Council Bluffs, IA 51503-9078
Phone
(712) 256-2561
Fax
(712) 256-1927
NPI assigned
Oct 6, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2011

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

Authorized official

Name
Dr. Tonweya Willow Langille, D.C.
Title
Doctor
Phone
(712) 256-2561

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 007034 IA Primary

Addresses

Primary practice location

300 W Broadway
Suite 712
Council Bluffs, IA 51503-9078

Mailing address

300 W Broadway
Suite 712
Council Bluffs, IA 51503-9078
Phone (712) 256-2561

Other identifiers 2

IdentifierTypeStateIssuer
0400821MedicaidIA
10025584600MedicaidNE

National Provider Directory

National Provider Directory

Locations

300 W Broadway
Ste 712
Council Bluffs, IA 51503
Phone (712) 256-2561

NPI Registry JSON

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1477837615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 W BROADWAY",
            "address_2": "SUITE 712",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515039078",
            "telephone_number": "712-256-2561",
            "fax_number": "712-256-1927"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 W BROADWAY",
            "address_2": "SUITE 712",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515039078",
            "telephone_number": "712-256-2561",
            "fax_number": "712-256-1927"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAIRIELANDS CHIROPRACTIC CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-06",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "LANGILLE",
        "authorized_official_first_name": "TONWEYA",
        "authorized_official_middle_name": "WILLOW",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "712-256-2561",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0400821",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10025584600",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Council Bluffs, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.