Organization Active NPI

Breitbach Office LLC

  • Chiropractor
  • Charles City, IA
National Provider Identifier
1609468669
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BREITBACH OFFICE LLC
Practice address
119 N Jackson St
Charles City, IA 50616-2002
Phone
(641) 228-1665
NPI assigned
Feb 10, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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

Authorized official

Name
Mary Breitbach
Title
Office Coordin & Register Agent LLC
Phone
(641) 228-1665

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

119 N Jackson St
Charles City, IA 50616-2002

Mailing address

119 N Jackson St
Charles City, IA 50616-2002
Phone (641) 228-1665

Other names 1

  • Breitbach Chiropractic Office Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210115002206 IA Part B Supplier - Clinic/Group Practice 5395158174 Receives reassigned benefits from 2 practitioners
Practice locations: Charles City, IA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
16D0384551Breitbach Chiropractic Office119 N Jackson St, Charles City, IA 50616Certificate of waiverAug 31, 2026

National Provider Directory

National Provider Directory

Locations

119 N Jackson St
Charles City, IA 50616
Phone (641) 228-1665

119 N Jackson St
Ofc Llc
Charles City, IA 50616
Phone (641) 228-1665

904 Ferguson St
Charles City, IA 50616
Phone (515) 228-1665

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673913600000",
    "number": "1609468669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 N JACKSON ST",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506162002",
            "telephone_number": "641-228-1665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 N JACKSON ST",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506162002",
            "telephone_number": "641-228-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREITBACH OFFICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-10",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A",
        "authorized_official_last_name": "BREITBACH",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "OFFICE COORDIN & REGISTER AGENT LLC",
        "authorized_official_telephone_number": "641-228-1665"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breitbach Chiropractic Office",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Breitbach Chiropractic Office",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Charles City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2023; 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.