Organization Active NPI

Tri-State Chiropractic Clinic, Inc.

  • Chiropractor
  • South Sioux City, NE
National Provider Identifier
1740264746
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
TRI-STATE CHIROPRACTIC CLINIC, INC.
Practice address
3900 Dakota Ave
Suite #6
South Sioux City, NE 68776-3696
Phone
(402) 494-5173
Fax
(402) 494-5151
NPI assigned
Dec 2, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Pat E Luse, D.C.
Title
President
Phone
(402) 494-5173

Specialties & licenses 1

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

Addresses

Primary practice location

3900 Dakota Ave
Suite #6
South Sioux City, NE 68776-3696

Mailing address

3900 Dakota Ave
Suite #6
South Sioux City, NE 68776-3696
Phone (402) 494-5173

Other identifiers 1

IdentifierTypeStateIssuer
0548594MedicaidIA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1740264746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3900 DAKOTA AVE",
            "address_2": "SUITE #6",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763696",
            "telephone_number": "402-494-5173",
            "fax_number": "402-494-5151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 DAKOTA AVE",
            "address_2": "SUITE #6",
            "city": "SOUTH SIOUX CITY",
            "state": "NE",
            "postal_code": "687763696",
            "telephone_number": "402-494-5173",
            "fax_number": "402-494-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE CHIROPRACTIC CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-12-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "LUSE",
        "authorized_official_first_name": "PAT",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "402-494-5173",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0548594",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in South Sioux City, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.