Individual provider Active NPI

Travis Dewitt, D.C.

  • Chiropractor
  • Cedar Rapids, IA
National Provider Identifier
1578949137
Registry record updated Aug 6, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
078815 Issued in IA
Practice address
4245 1St Ave SE
Cedar Rapids, IA 52402-3169
Phone
(319) 329-5946
NPI assigned
Aug 6, 2015
Last updated
Aug 6, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 078815 IA Primary

Addresses

Primary practice location

4245 1St Ave SE
Cedar Rapids, IA 52402-3169

Mailing address

4245 1St Ave SE
Cedar Rapids, IA 52402-3169
Phone (319) 329-5946

Other names 1

  • Travis Beall Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150923000165 IA Practitioner - Chiropractic 1759698855 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dewitt Family Chiropractic PCGroup PAC ID 8123335221, 2 clinicians

Practice addresses (Care Compare)

2441 Coral CT
Suite 1
Coralville, IA 52241-2872
Phone (319) 545-2295

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078815IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dewitt Family Chiropractic PC CurrentSince Oct 1, 2015 Accepting new patients

Locations

4245 1st Ave SE
Cedar Rapids, IA 52402
Phone (319) 364-5321

2441 Coral Ct
Ste 1
Coralville, IA 52241
Phone (319) 545-2295

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1438819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438819200000",
    "number": "1578949137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4245 1ST AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023169",
            "telephone_number": "319-329-5946"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4245 1ST AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023169",
            "telephone_number": "319-329-5946"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWITT",
        "first_name": "TRAVIS",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-06",
        "last_updated": "2015-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "078815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TRAVIS",
            "last_name": "BEALL",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Aug 6, 2015; 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.