Organization Active NPI

Juergens Chiropractic & Acupuncture PLLC

  • Chiropractor
  • Carroll, IA
National Provider Identifier
1558734699
Registry record updated Nov 11, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
079947 Issued in IA
Legal business name
JUERGENS CHIROPRACTIC & ACUPUNCTURE PLLC
Practice address
410 W 3Rd St
Carroll, IA 51401-2230
Phone
(712) 792-3716
Fax
(712) 792-3716
NPI assigned
Nov 11, 2015
Last updated
Nov 11, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2015

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

Authorized official

Name
Dr. Peter Edward Juergens, D.C.NPI 1912370206
Title
Chiropractor
Phone
(712) 792-3716

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
Chiropractor 111N00000X 079947 IA Primary

Addresses

Primary practice location

410 W 3Rd St
Carroll, IA 51401-2230

Mailing address

410 W 3Rd St
Carroll, IA 51401-2230
Phone (712) 792-3716

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151214002318 IA Part B Supplier - Clinic/Group Practice 6305147471 Receives reassigned benefits from 1 practitioner
Practice locations: Carroll, IA

National Provider Directory

National Provider Directory

Locations

410 W 3rd St
Carroll, IA 51401
Phone (712) 792-3716

Practitioners & affiliated clinicians

Practitioners 2

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": "1447200000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1447200000000",
    "number": "1558734699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 W 3RD ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514012230",
            "telephone_number": "712-792-3716",
            "fax_number": "712-792-3716"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 W 3RD ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "514012230",
            "telephone_number": "712-792-3716",
            "fax_number": "712-792-3716"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUERGENS CHIROPRACTIC & ACUPUNCTURE PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-11-11",
        "last_updated": "2015-11-11",
        "status": "A",
        "authorized_official_last_name": "JUERGENS",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "712-792-3716",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "079947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 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.