Individual provider Active NPI

Korey J Zwiefel, DC

  • Chiropractor
  • Clear Lake, IA
National Provider Identifier
1609843283
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05999 Issued in IA
Practice address
401 S 15TH St
Clear Lake, IA 50428
Phone
(641) 357-3393
Fax
(641) 357-4228
NPI assigned
Mar 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05999 IA Primary

Addresses

Primary practice location

401 S 15TH St
Clear Lake, IA 50428

Mailing address

401 S 15TH St
Clear Lake, IA 50428
Phone (641) 357-3393

Other identifiers 2

IdentifierTypeStateIssuer
1155234MedicaidIA
41833OtherIABLUE SHIELD COMMERCIAL

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

LicenseStateTypeSpecialty
A05999IAMDChiropractor

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, 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": "1141257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1609843283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 S 15TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "50428",
            "telephone_number": "641-357-3393",
            "fax_number": "641-357-4228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 S 15TH ST",
            "city": "CLEAR LAKE",
            "state": "IA",
            "postal_code": "50428",
            "telephone_number": "641-357-3393",
            "fax_number": "641-357-4228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZWIEFEL",
        "first_name": "KOREY",
        "middle_name": "J",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-02",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05999",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1155234",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD COMMERCIAL",
            "identifier": "41833",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clear Lake, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.