Organization Active NPI

Hartzell Family Chiropractic, P.L.C.

  • Chiropractor
  • Waterloo, IA
National Provider Identifier
1669654356
Registry record updated Apr 23, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06877 Issued in IA
Legal business name
HARTZELL FAMILY CHIROPRACTIC, P.L.C.
Practice address
509 Ansborough Ave
Ste a
Waterloo, IA 50701-2139
Phone
(319) 226-4404
Fax
(319) 226-4406
NPI assigned
Dec 4, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2008

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

Authorized official

Name
Dr. Jill Ann Hartzell, D.C.
Title
President
Phone
(319) 226-4404

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 06877 IA Primary

Addresses

Primary practice location

509 Ansborough Ave
Ste a
Waterloo, IA 50701-2139

Mailing address

509 Ansborough Ave
Ste a
Waterloo, IA 50701-2139
Phone (319) 226-4404

Other identifiers 2

IdentifierTypeStateIssuer
0486209MedicaidIA
I17438OtherIAMEDICARE ID-PIN

National Provider Directory

National Provider Directory

Locations

509 Ansborough Ave
Ste A
Waterloo, IA 50701
Phone (319) 226-4404

NPI Registry JSON

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208908800000",
    "number": "1669654356",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 ANSBOROUGH AVE",
            "address_2": "STE A",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012139",
            "telephone_number": "319-226-4404",
            "fax_number": "319-226-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 ANSBOROUGH AVE",
            "address_2": "STE A",
            "city": "WATERLOO",
            "state": "IA",
            "postal_code": "507012139",
            "telephone_number": "319-226-4404",
            "fax_number": "319-226-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARTZELL FAMILY CHIROPRACTIC, P.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-04",
        "last_updated": "2008-04-23",
        "status": "A",
        "authorized_official_last_name": "HARTZELL",
        "authorized_official_first_name": "JILL",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "319-226-4404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06877",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0486209",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID-PIN",
            "identifier": "I17438",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Waterloo, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2008; 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.