Individual provider Active NPI

Damon C Dornbier, D.C.

  • Chiropractor
  • Mason City, IA
National Provider Identifier
1811960586
Registry record updated Mar 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A5433 Issued in IA
Practice address
1315 6TH St SW
Mason City, IA 50401-4815
Phone
(641) 424-5171
Fax
(641) 423-1014
NPI assigned
Feb 10, 2006
Last updated
Mar 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A5433 IA Primary

Addresses

Primary practice location

1315 6TH St SW
Mason City, IA 50401-4815

Mailing address

1315 6TH St SW
Mason City, IA 50401-4815
Phone (641) 424-5171

Other identifiers 2

IdentifierTypeStateIssuer
29330OtherIABLUE CROSS BLUE SHIELD
0069591MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170728002276 TN Practitioner - Chiropractic 1456343821 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

280 S Jefferson Ave
Wellspring Family Chiropractic
Cookeville, TN 38501-3453
Phone (931) 528-5284

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A5433IAMDChiropractor
2870TNMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Dornbier Enterprise Inc Chiropractor CurrentSince May 30, 2017 Accepting new patients
Eastern Star LLC Chiropractor PastSince Jun 15, 2017 Accepting new patients

Locations

280 S Jefferson Ave
Cookeville, TN 38501
Phone (931) 528-5284

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": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331596800000",
    "number": "1811960586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1315 6TH ST SW",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504014815",
            "telephone_number": "641-424-5171",
            "fax_number": "641-423-1014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1315 6TH ST SW",
            "city": "MASON CITY",
            "state": "IA",
            "postal_code": "504014815",
            "telephone_number": "641-424-5171",
            "fax_number": "641-423-1014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DORNBIER",
        "first_name": "DAMON",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2012-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A5433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "29330",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0069591",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2012; 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.