Jiwa Chiropractic & Wellness

Primary specialty

ChiropractorTaxonomy code 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

Last updated

Oct 17, 2024By the provider in NPPES

Organization subpart

Yes

Parent organization

JIWA CHIROPRACTIC & WELLNESSAs reported in NPPES

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

Authorized official

Name

Joanna Widjaja, DCNPI 1639909682

Title

Chiropractor

Phone

(712) 301-7537

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Part of

Jiwa Chiropractic Wellness

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joanna Wenas Widjaja, DC

  • Chiropractor
  • Sergeant Bluff, IA
  • NPI 1639909682
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1729123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729123200000",
    "number": "1699596114",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 1ST ST STE 111",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548532",
            "telephone_number": "712-823-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 1ST ST STE 111",
            "city": "SERGEANT BLUFF",
            "state": "IA",
            "postal_code": "510548532",
            "telephone_number": "712-823-3127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIWA CHIROPRACTIC & WELLNESS",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "JIWA CHIROPRACTIC & WELLNESS",
        "enumeration_date": "2024-10-17",
        "last_updated": "2024-10-17",
        "certification_date": "2024-10-17",
        "status": "A",
        "authorized_official_last_name": "WIDJAJA",
        "authorized_official_first_name": "JOANNA",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "712-301-7537",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Jane Handke, ARNP
• Hawkeye Clinic of Sergeant Bluff, PC
• John Addison Hildman
• Renee L. Husen, D.D.S.
• Stacey A Jackson, PHARMD
• JP Senior Healthcare LLC (Pioneer Valley Living and Rehab Center)
• Kismet Sux LLC (WEL-Home Health Sergeant Bluff)
• Kismet Sux LLC (Embassy Rehab and Care Center)
• Bonnie Sue Knutson, PTA
• Katelyn Jean Kudrna, O.D.

• Chiropractor in Sergeant Bluff, IA
• Providers in Sergeant Bluff, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.