Organization Active NPI

Bondurant Family Chiropractic, PC

  • Pediatric Chiropractor
  • Bondurant, IA
National Provider Identifier
1508240870
Registry record updated Aug 21, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric ChiropractorTaxonomy code 111NP0017X
License
007522 Issued in IA
Legal business name
BONDURANT FAMILY CHIROPRACTIC, PC
Practice address
210 2ND St NE Ste C
Bondurant, IA 50035-1336
Phone
(319) 400-2668
NPI assigned
Jul 16, 2015
Last updated
Aug 21, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2015

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

Authorized official

Name
Laura Mooney, D.C., DICCPNPI 1760757678
Title
Director Doctor
Phone
(319) 400-2668

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NP0017X 007522 IA Primary

Addresses

Primary practice location

210 2ND St NE Ste C
Bondurant, IA 50035-1336

Mailing address

301 Center Ave S
Mitchellville, IA 50169-9751

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150922002628 IA Part B Supplier - Clinic/Group Practice 4688981764 Receives reassigned benefits from 3 practitioners
Practice locations: Bondurant, IA

National Provider Directory

National Provider Directory

Locations

210 2nd St NE
Ste C
Bondurant, IA 50035
Phone (515) 710-0789

301 Center Ave S
Mitchellville, IA 50169
Phone (515) 967-2700

Practitioners & affiliated clinicians

Practitioners 3

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": "1437004800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440115200000",
    "number": "1508240870",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 CENTER AVE S",
            "city": "MITCHELLVILLE",
            "state": "IA",
            "postal_code": "501699751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 2ND ST NE STE C",
            "city": "BONDURANT",
            "state": "IA",
            "postal_code": "500351336",
            "telephone_number": "319-400-2668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BONDURANT FAMILY CHIROPRACTIC, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-16",
        "last_updated": "2015-08-21",
        "status": "A",
        "authorized_official_last_name": "MOONEY",
        "authorized_official_first_name": "LAURA",
        "authorized_official_title_or_position": "DIRECTOR DOCTOR",
        "authorized_official_telephone_number": "319-400-2668",
        "authorized_official_credential": "D.C., DICCP"
    },
    "taxonomies": [
        {
            "code": "111NP0017X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Pediatric Chiropractor",
            "state": "IA",
            "license": "007522",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bondurant, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2015; 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.