Troy Eden, DC
Individual provider Active NPI Chiropractor · De Witt, IA
NPI 1619993151 · NPPES record last updated Oct 9, 2013
Key facts
- NPI
- 1619993151
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- A06106 (IA)
- Practice address
- 1419A 11TH St
De Witt, IA 52742-1247 - Phone
- (563) 659-9039
- NPI assigned
- Jul 15, 2006
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1419 11TH St
Suite a
De Witt, IA 52742-1294
Phone (563) 659-9039
1419 11TH St a
De Witt, IA 52742-1294
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040202000974 | IA | Practitioner - Chiropractic | 7214820505 |
Receives reassigned benefits from 1 practitioner Practice locations: De Witt, IA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | A06106 | IA | Yes |
Addresses
Primary practice location
1419A 11TH St
De Witt, IA 52742-1247
Mailing address
1419 11TH St Ste a
De Witt, IA 52742-1294
Phone (563) 659-9039
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0243485 | Medicaid | IA | |
| 45735 | Other | IA | BLUE CROSS BLUE SHIELD |
Other providers in De Witt, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2013. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.