CCC PC
Organization Active NPI Chiropractor · Red Oak, IA
NPI 1740290907 · NPPES record last updated Jun 21, 2018
Key facts
- NPI
- 1740290907
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 06364 (IA)
- Legal business name
- CCC PC
- Practice address
- 404 N 5TH St
P.O. 407
Red Oak, IA 51566-2323 - Phone
- (712) 623-3526
- NPI assigned
- Aug 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Kelli S Confer, DC
- Title
- President Owner
- Phone
- (712) 623-3526
Practitioners 1
-
Kelli S. Confer, D.C.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20070109000595 | IA | Part B Supplier - Clinic/Group Practice | 6507866928 |
Receives reassigned benefits from 1 practitioner Practice locations: Red Oak, IA |
National Provider Directory
Locations
404 N 5th St
Red Oak, IA 51566
Phone (712) 527-2689
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 06364 | IA | Yes |
Addresses
Primary practice location
404 N 5TH St
P.O. 407
Red Oak, IA 51566-2323
Mailing address
404 No 5TH St
P.O. 407
Red Oak, IA 51566-2323
Phone (712) 623-3526
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 231944 | Other | IA | MIDLANDS CHOICE |
| 24813 | Other | IA | BCBS |
| 484847348 | Other | IA | SS# |
Other providers in Red Oak, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 21, 2018. 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.