Active NPI
Matthew Paul Potratz, D.C.
- Chiropractor
- Shenandoah, IA
National Provider Identifier
1487922894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 007472
- Practice address
- 813 Church St
Shenandoah, IA 51601-2301 - Phone
- (712) 246-5954
- Fax
- (712) 246-3269
- NPI assigned
- Dec 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 007472 | IA | Primary |
Addresses
Primary practice location
813 Church St
Shenandoah, IA 51601-2301
Mailing address
813 Church St
Shenandoah, IA 51601-2301
Phone (712) 246-5954
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1323734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1323734400000",
"number": "1487922894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "813 CHURCH ST",
"city": "SHENANDOAH",
"state": "IA",
"postal_code": "516012301",
"telephone_number": "712-246-5954",
"fax_number": "712-246-3269"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "813 CHURCH ST",
"city": "SHENANDOAH",
"state": "IA",
"postal_code": "516012301",
"telephone_number": "712-246-5954",
"fax_number": "712-246-3269"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POTRATZ",
"first_name": "MATTHEW",
"middle_name": "PAUL",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-13",
"last_updated": "2011-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "007472",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shenandoah, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.