Matthew Lawrence Waack, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

06673 Issued in IA

Practice address

115 McKinsey Dr
Maquoketa, IA 52060-2014

Phone

(563) 652-6884

NPI assigned

Mar 20, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2000

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Douglas Grant Leon, DC

  • Chiropractor
  • Maquoketa, IA
  • NPI 1932154044
  Medicare reassignment
• Leon Chiropractic LLC

  • Chiropractor
  • Maquoketa, IA
  • NPI 1659762920
  NPD (past)

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1801911011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 MCKINSEY DR",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602014",
            "telephone_number": "563-652-6884"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 MCKINSEY DR",
            "city": "MAQUOKETA",
            "state": "IA",
            "postal_code": "520602014",
            "telephone_number": "563-652-6884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WAACK",
        "first_name": "MATTHEW",
        "middle_name": "LAWRENCE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06673",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "13914",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0443788",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Timber City Chiropractic Inc
• Farah Marie Towfic, PHARMD
• Clifford James Trilk, CRNA
• Megan Elizabeth Vance
• Sabrina Vonderhaar, LMHC, IADC
• Wayne L Wagoner, DPM
• Bradley B Waller, MD
• Roger R Waller, MD
• Walmart Inc. (Walmart Pharmacy 10-1509)
• Wayne L. Wagoner, DPM, PC

• Chiropractor in Maquoketa, IA
• Providers in Maquoketa, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.