Organization Active NPI

Essentially Innate Chiropractic & Wellness, PC

  • Chiropractor
  • Gibbon, NE
National Provider Identifier
1497487177
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ESSENTIALLY INNATE CHIROPRACTIC & WELLNESS, PC
Practice address
812 Court St Ste B
Gibbon, NE 68840-3117
Phone
(308) 270-1240
Fax
(308) 270-1245
NPI assigned
Jun 30, 2022
Last updated
Jun 30, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Authorized official

Name
Dr. Camie K Rose, DC
Title
President of Essentially Innate CHI
Phone
(308) 270-1240

Specialties & licenses 1

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

Addresses

Primary practice location

812 Court St Ste B
Gibbon, NE 68840-3117

Mailing address

812 Court St Ste B
Gibbon, NE 68840-3117
Phone (308) 270-1240

Other identifiers 1

IdentifierTypeStateIssuer
10027039200MedicaidNE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220801002406 NE Part B Supplier - Clinic/Group Practice 3072995422 Receives reassigned benefits from 1 practitioner
Practice locations: Gibbon, NE

National Provider Directory

National Provider Directory

Locations

812 Court St
Ste B
Gibbon, NE 68840
Phone (308) 270-1240

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1656547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656547200000",
    "number": "1497487177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "812 COURT ST STE B",
            "city": "GIBBON",
            "state": "NE",
            "postal_code": "688403117",
            "telephone_number": "308-270-1240",
            "fax_number": "308-270-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 COURT ST STE B",
            "city": "GIBBON",
            "state": "NE",
            "postal_code": "688403117",
            "telephone_number": "308-270-1240",
            "fax_number": "308-270-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ESSENTIALLY INNATE CHIROPRACTIC & WELLNESS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-30",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "CAMIE",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "PRESIDENT OF ESSENTIALLY INNATE CHI",
        "authorized_official_telephone_number": "308-270-1240",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10027039200",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gibbon, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; 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.