Siouxland Family Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

06785 Issued in IA

Legal business name

SIOUXLAND FAMILY CHIROPRACTIC PC

Practice address

966 Westview Dr
Rock Valley, IA 51247-7485

Phone

(712) 476-3355

Fax

(712) 476-2199

NPI assigned

Jun 13, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Coreen Lynn Montag, D.C.

Title

President

Phone

(712) 476-3355

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760686661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "966 WESTVIEW DR",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512477485",
            "telephone_number": "712-476-3355",
            "fax_number": "712-476-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "966 WESTVIEW DR",
            "city": "ROCK VALLEY",
            "state": "IA",
            "postal_code": "512477485",
            "telephone_number": "712-476-3355",
            "fax_number": "712-476-2199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIOUXLAND FAMILY CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MONTAG",
        "authorized_official_first_name": "COREEN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "712-476-3355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06785",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "046811",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.