Individual provider Active NPI

Shannon Cody Woodward, D.C.

  • Chiropractor
  • Bettendorf, IA
National Provider Identifier
1548358450
Registry record updated Jan 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06572 Issued in IA
Practice address
3359 Middle Rd Ste 1
Bettendorf, IA 52722-3402
Phone
(563) 332-2211
Fax
(563) 332-2210
NPI assigned
Oct 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 06572 IA Primary

Addresses

Primary practice location

3359 Middle Rd Ste 1
Bettendorf, IA 52722-3402

Mailing address

3359 Middle Rd Ste 1
Bettendorf, IA 52722-3402
Phone (563) 332-2211

Other practice location 1

1608 S 19th St
Clinton, IA 52732-6702
Phone (563) 242-2002

Other identifiers 1

IdentifierTypeStateIssuer
28081OtherIABLUE CROSS BLUE SHIELD

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

Practice roles

OrganizationSpecialtyStatusNew patients
Todd M Slattery P C Chiropractor Past Accepting new patients
Hawkeye Chiropractic Inc. Chiropractor PastSince Oct 30, 2006 Accepting new patients
My Chiro, L.L.C. Chiropractor PastSince Apr 19, 2012 Accepting new patients

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": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1548358450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3359 MIDDLE RD STE 1",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223402",
            "telephone_number": "563-332-2211",
            "fax_number": "563-332-2210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3359 MIDDLE RD STE 1",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223402",
            "telephone_number": "563-332-2211",
            "fax_number": "563-332-2210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1608 S 19th St",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "IA",
            "postal_code": "527326702",
            "country_code": "US",
            "telephone_number": "563-242-2002",
            "fax_number": "563-242-0889",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOODWARD",
        "first_name": "SHANNON",
        "middle_name": "CODY",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "28081",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.