Jiwa Chiropractic & Wellness
Organization Active NPI Chiropractor · Sergeant Bluff, IA
NPI 1699596114 · NPPES record last updated Oct 17, 2024
Key facts
- NPI
- 1699596114
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- JIWA CHIROPRACTIC & WELLNESS
- Practice address
- 204 1St St Ste 111
Sergeant Bluff, IA 51054-8532 - Phone
- (712) 823-3127
- NPI assigned
- Oct 17, 2024
- Organization subpart
- Yes
- Parent organization (as reported)
- JIWA CHIROPRACTIC & WELLNESS
Authorized official
- Name
- Joanna Widjaja, DC
- Title
- Chiropractor
- Phone
- (712) 301-7537
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250428001816 | IA | Part B Supplier - Clinic/Group Practice | 5799201331 |
Receives reassigned benefits from 1 practitioner Practice locations: Sergeant Bluff, IA |
National Provider Directory
- Part of
- Jiwa Chiropractic Wellness
Locations
204 1st St
Ste 111
Sergeant Bluff, IA 51054
Phone (712) 301-7537
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
204 1St St Ste 111
Sergeant Bluff, IA 51054-8532
Mailing address
204 1St St Ste 111
Sergeant Bluff, IA 51054-8532
Phone (712) 823-3127
Other providers in Sergeant Bluff, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 17, 2024. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.