Individual provider Active NPI

Jamison Dean Vanroekel, D.C.

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1730456419
Registry record updated Mar 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1811 Issued in NE
Practice address
920 S 107TH Ave
Ste 109
Omaha, NE 68114-4719
Phone
(402) 835-5885
Fax
(402) 835-5995
NPI assigned
Nov 22, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007468 IA
Chiropractor 111N00000X 1811 NE Primary

Addresses

Primary practice location

920 S 107TH Ave
Ste 109
Omaha, NE 68114-4719

Mailing address

920 S 107TH Ave
Ste 109
Omaha, NE 68114-4719
Phone (402) 835-5885

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170405001288 NE Practitioner - Chiropractic 8426215674 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

913 S 87TH Ave
Omaha, NE 68114-5219
Phone (402) 835-5885

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1811NEMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Omaha Central Chiropractic LLC Chiropractor CurrentSince Mar 1, 2017 Accepting new patients
Mouw Chiropractic & Spinal Rehabilitation Center, P.C. Chiropractor CurrentSince Nov 28, 2011 Accepting new patients

Locations

20 Power Dr
Ste 1
Council Bluffs, IA 51501
Phone (712) 366-1611

913 S 87th Ave
Omaha, NE 68114
Phone (402) 835-5885

920 S 107th Ave
Ste 109
Omaha, NE 68114
Phone (402) 835-5885

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1321920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490054400000",
    "number": "1730456419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S 107TH AVE",
            "address_2": "STE 109",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144719",
            "telephone_number": "402-835-5885",
            "fax_number": "402-835-5995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S 107TH AVE",
            "address_2": "STE 109",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681144719",
            "telephone_number": "402-835-5885",
            "fax_number": "402-835-5995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANROEKEL",
        "first_name": "JAMISON",
        "middle_name": "DEAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-22",
        "last_updated": "2017-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007468",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NE",
            "license": "1811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; 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.