Individual provider Active NPI

Trevor Frank Tennant, D.C.

  • Chiropractor
  • Clinton, IA
National Provider Identifier
1720417124
Registry record updated Jul 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007705 Issued in IA
Practice address
951 13TH Ave N
Clinton, IA 52732
Phone
(563) 242-5375
Fax
(563) 243-5375
NPI assigned
Nov 6, 2013
Last updated
Jul 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007705 IA Primary

Addresses

Primary practice location

951 13TH Ave N
Clinton, IA 52732

Mailing address

951 13TH Ave N
Clinton, IA 52732-5032
Phone (563) 242-5375

Other practice location 1

927 N 2nd St
Suite B
Clinton, IA 52732-3750
Phone (563) 242-5375

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140210001665 IA Practitioner - Chiropractic 4486883642 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

951 13TH Ave N
Clinton, IA 52732-5032
Phone (563) 242-5375

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007705IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Clinton Back and Neck Family Wellness, PC Chiropractor CurrentSince Nov 5, 2013 Accepting new patients

Locations

951 13th Ave N
Clinton, IA 52732
Phone (319) 242-7334

927 N 2nd St
Ste B
Clinton, IA 52732
Phone (319) 409-6922

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": "1383696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532390400000",
    "number": "1720417124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "951 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527325032",
            "telephone_number": "563-242-5375",
            "fax_number": "563-243-5375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "951 13TH AVE N",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "52732",
            "telephone_number": "563-242-5375",
            "fax_number": "563-243-5375"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "927 N 2nd St",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Clinton",
            "state": "IA",
            "postal_code": "527323750",
            "country_code": "US",
            "telephone_number": "563-242-5375",
            "fax_number": "563-243-5375",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "TREVOR",
        "middle_name": "FRANK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-06",
        "last_updated": "2018-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2018; 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.