Individual provider Active NPI

Brent Lane Lindberg, DC

  • Chiropractor
  • Ottumwa, IA
National Provider Identifier
1639133598
Registry record updated Jul 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05930 Issued in IA
Practice address
297 Richmond Ave
Ottumwa, IA 52501
Phone
(641) 682-8301
Fax
(641) 682-8301
NPI assigned
Apr 17, 2006
Last updated
Jul 12, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05930 IA Primary

Addresses

Primary practice location

297 Richmond Ave
Ottumwa, IA 52501

Mailing address

297 Richmond Ave
Ottumwa, IA 52501
Phone (641) 682-8301

Other identifiers 1

IdentifierTypeStateIssuer
0139899MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101021000246 IA Practitioner - Chiropractic 2567655624 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ottumwa Chiropractic Clinic PCGroup PAC ID 1355705443, 2 clinicians

Practice addresses (Care Compare)

297 Richmond Ave
Ottumwa, IA 52501-4227
Phone (641) 682-0708

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ottumwa Chiropractic Clinic PC Chiropractor CurrentSince Jul 10, 2023 Accepting new patients

Locations

297 Richmond Ave
Ottumwa, IA 52501
Phone (515) 682-0708

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": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278892800000",
    "number": "1639133598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "297 RICHMOND AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "52501",
            "telephone_number": "641-682-8301",
            "fax_number": "641-682-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "297 RICHMOND AVE",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "52501",
            "telephone_number": "641-682-8301",
            "fax_number": "641-682-8301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LINDBERG",
        "first_name": "BRENT",
        "middle_name": "LANE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2010-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05930",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0139899",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ottumwa, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2010; 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.