Individual provider Active NPI

Corey Modrell, D.C.

  • Chiropractor
  • Montrose, CO
National Provider Identifier
1487600805
Registry record updated May 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
CH5860 Issued in CO
Practice address
1550 East Niagara Rd
Montrose, CO 81401-5027
Phone
(970) 240-4500
Fax
(970) 240-4897
NPI assigned
May 26, 2006
Last updated
May 6, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH5860 CO Primary

Addresses

Primary practice location

1550 East Niagara Rd
Montrose, CO 81401-5027

Mailing address

1550 Niagara Rd
Montrose, CO 81401-5027
Phone (970) 240-4500

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170224000856 AK Practitioner - Chiropractic 3072520527 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Arctic Chiropractic East Mat-Su LLCGroup PAC ID 5193001600, 8 clinicians

Practice addresses (Care Compare)

1734 N Prospect Dr
Palmer, AK 99645-9655
Phone (907) 746-7842

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CH5860COMDChiropractor
5860COMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Arctic Chiropractic East Mat-Su LLC Chiropractor CurrentSince Jan 21, 2017 Accepting new patients
Arctic Medical Center Matsu CurrentSince Aug 1, 2020 Accepting new patients
Modrell Family and Sports Chiropractic, Inc Chiropractor PastSince Feb 2, 2010 Accepting new patients

Locations

1150 S Colony Way
Ste 3
Palmer, AK 99645

Organizations & group practices 3

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": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1273104000000",
    "number": "1487600805",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 NIAGARA RD",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015027",
            "telephone_number": "970-240-4500",
            "fax_number": "970-240-4897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 EAST NIAGARA RD",
            "city": "MONTROSE",
            "state": "CO",
            "postal_code": "814015027",
            "telephone_number": "970-240-4500",
            "fax_number": "970-240-4897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MODRELL",
        "first_name": "COREY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-26",
        "last_updated": "2010-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CO",
            "license": "CH5860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montrose, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.