Individual provider Active NPI

Erin E Komp, D.C

  • Chiropractor
  • Council Bluffs, IA
National Provider Identifier
1487948378
Registry record updated Jun 8, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007417 Issued in IA
Practice address
40 Arena Way
Suite 1
Council Bluffs, IA 51501-7062
Phone
(712) 329-1863
Fax
(712) 323-1089
NPI assigned
Jun 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007417 IA Primary

Addresses

Primary practice location

40 Arena Way
Suite 1
Council Bluffs, IA 51501-7062

Mailing address

40 Arena Way
Suite 1
Council Bluffs, IA 51501-7062
Phone (712) 329-1863

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120221000777 NE Practitioner - Chiropractic 2860650991 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Cleveland Chiropractic College - Kansas City, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Universal Wellness Source of Omaha, LLCGroup PAC ID 4587083290, 2 clinicians

Practice addresses (Care Compare)

5331 S 204TH Ave
Suite 2
Elkhorn, NE 68022-4385
Phone (531) 867-3720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007417IAMDChiropractor
1686NEMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Universal Wellness Source of Omaha LLC Chiropractor CurrentSince Jan 23, 2023 Accepting new patients
Total Care Chiropractic LTD Chiropractor PastSince Aug 9, 2004 Accepting new patients
Millard Family Chiropractic of Papillion LLC Chiropractor PastSince Dec 5, 2011 Accepting new patients

Locations

5331 S 204th Ave
Ste 2
Elkhorn, NE 68022
Phone (531) 867-3720

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1307491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1307491200000",
    "number": "1487948378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "40 ARENA WAY",
            "address_2": "SUITE 1",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515017062",
            "telephone_number": "712-329-1863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "40 ARENA WAY",
            "address_2": "SUITE 1",
            "city": "COUNCIL BLUFFS",
            "state": "IA",
            "postal_code": "515017062",
            "telephone_number": "712-329-1863",
            "fax_number": "712-323-1089"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMP",
        "first_name": "ERIN",
        "middle_name": "E",
        "credential": "D.C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-08",
        "last_updated": "2011-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007417",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jun 8, 2011; 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.