Active NPI
Wendell L Utech, D.C.
- Chiropractor
- Grinnell, IA
National Provider Identifier
1588640494
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 4492
- Practice address
- 603 6TH Ave
Grinnell, IA 50112-1942 - Phone
- (641) 236-8988
- Fax
- (641) 236-8172
- NPI assigned
- Dec 22, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 4492 | IA | Primary |
Addresses
Primary practice location
603 6TH Ave
Grinnell, IA 50112-1942
Mailing address
603 6TH Ave
Grinnell, IA 50112-1942
Phone (641) 236-8988
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 08640 | Other | IA | BC/BS OF IOWA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4492 | IA | MD | Chiropractor |
| 04492 | IA | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Converge Chiropractic PLLC | Chiropractor | Current | Accepting new patients |
Locations
603 6th Ave
Grinnell, IA 50112
Phone (641) 236-8988
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.
-
- Chiropractor
- Grinnell, IA
- NPI 1881213726
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1135209600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1588640494",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 6TH AVE",
"city": "GRINNELL",
"state": "IA",
"postal_code": "501121942",
"telephone_number": "641-236-8988",
"fax_number": "641-236-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "603 6TH AVE",
"city": "GRINNELL",
"state": "IA",
"postal_code": "501121942",
"telephone_number": "641-236-8988",
"fax_number": "641-236-8172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTECH",
"first_name": "WENDELL",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-12-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "4492",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS OF IOWA",
"identifier": "08640",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Grinnell, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.