Individual provider Active NPI

Amanda Jo O'Sullivan, D.C.

  • Chiropractor
  • Cedar Rapids, IA
National Provider Identifier
1518303163
Registry record updated May 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007664 Issued in IA
Practice address
214 Blairs Ferry Rd NE Ste 2
Cedar Rapids, IA 52402-1602
Phone
(319) 378-1515
Fax
(319) 378-9292
NPI assigned
May 21, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 21, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007664 IA Primary

Addresses

Primary practice location

214 Blairs Ferry Rd NE Ste 2
Cedar Rapids, IA 52402-1602

Mailing address

214 Blairs Ferry Rd NE Ste 2
Cedar Rapids, IA 52402-1602
Phone (319) 378-1515

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130705000289 IA Practitioner - Chiropractic 7315187838 Reassigns benefits to 1 organization
Practice locations: Cedar Rapids, IA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

214 Blairs Ferry Rd NE
Suite 2
Cedar Rapids, IA 52402-1602
Phone (319) 378-1515

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007664IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
O'Sullivan Family Chiropractic Inc Chiropractor CurrentSince Jul 1, 2017 Accepting new patients

Locations

214 Blairs Ferry Rd NE
Ste 2
Cedar Rapids, IA 52402
Phone (319) 331-8634

214 Blairs Ferry Rd NE
Cedar Rapids, IA 52402
Phone (319) 378-1515

Organizations & group practices 1

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": "1369094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1369094400000",
    "number": "1518303163",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "214 BLAIRS FERRY RD NE STE 2",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524021602",
            "telephone_number": "319-378-1515",
            "fax_number": "319-378-9292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "214 BLAIRS FERRY RD NE STE 2",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524021602",
            "telephone_number": "319-378-1515",
            "fax_number": "319-378-9292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "O'SULLIVAN",
        "first_name": "AMANDA",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-05-21",
        "last_updated": "2013-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2013; 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.