Traer Chiropractic
Organization Active NPI Chiropractor · Traer, IA
NPI 1609229582 · NPPES record last updated Aug 24, 2016
Key facts
- NPI
- 1609229582
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- A05449 (IA)
- Legal business name
- TRAER CHIROPRACTIC
- Practice address
- 551 2ND St
Traer, IA 50675-1138 - Phone
- (319) 478-8515
- NPI assigned
- Jul 15, 2016
- Organization subpart
- No
Authorized official
- Name
- Dr. Jimmy Jay Smith, D.C.
- Title
- Owner
- Phone
- (319) 240-3922
Practitioners 3
-
Jimmy J Smith, DC
-
Steven William Hanus, D.C.
-
Ashley Lyn Reid, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20160829000356 | IA | Part B Supplier - Clinic/Group Practice | 8022303155 |
Receives reassigned benefits from 2 practitioners Practice locations: Traer, IA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | A05449 | IA | Yes |
Addresses
Primary practice location
551 2ND St
Traer, IA 50675-1138
Mailing address
4132 Harbin Dr
Waterloo, IA 50701-9745
Phone (319) 240-3922
Other providers in Traer, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.