Individual provider Active NPI

Cory M Thiele, D.C.

  • Chiropractor
  • West Des Moines, IA
National Provider Identifier
1811062441
Registry record updated Aug 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
072217 Issued in IA
Practice address
5010 Mills Civic Pkwy Ste 102
West Des Moines, IA 50265-5267
Phone
(515) 777-9771
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2014

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CH00034266 WA
Chiropractor 111N00000X 038.011478 IL
Chiropractor 111N00000X 3670 OR
Chiropractor 111N00000X 072217 IA Primary

Addresses

Primary practice location

5010 Mills Civic Pkwy Ste 102
West Des Moines, IA 50265-5267

Mailing address

5010 Mills Civic Pkwy Ste 102
West Des Moines, IA 50265-5267
Phone (515) 777-9771

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140402001854 IA Practitioner - Chiropractic 7416001953 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

5010 Mills Civic Pkwy
Suite 102
West Des Moines, IA 50265-5267
Phone (515) 777-9771

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
072217IAMDChiropractor
038.011478ILMDChiropractor
3670ORMDChiropractor
CH00034266WAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thiele Chiropractic & Wellness, LLC CurrentSince Feb 18, 2014 Accepting new patients
Hulsebus Rockford Chiropractic Chiropractor PastSince Jan 1, 2010 Accepting new patients
Simmer Chiropractic & Wellness Inc. Chiropractor Past Accepting new patients

Locations

5010 Mills Civic Pkwy
Ste 102
West Des Moines, IA 50265
Phone (515) 777-9771

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407196800000",
    "number": "1811062441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5010 MILLS CIVIC PKWY STE 102",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655267",
            "telephone_number": "515-777-9771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5010 MILLS CIVIC PKWY STE 102",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502655267",
            "telephone_number": "515-777-9771"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIELE",
        "first_name": "CORY",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2014-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "WA",
            "license": "CH00034266",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011478",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OR",
            "license": "3670",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "072217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2014; 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.