Individual provider Active NPI

Rebecca J. Swella Smedsrud, D.C.

  • Chiropractor
  • Decorah, IA
National Provider Identifier
1811977473
Registry record updated Sep 26, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05780 Issued in IA
Practice address
810 S Mechanic St
Decorah, IA 52101-2146
Phone
(563) 382-3801
Fax
(563) 387-0004
NPI assigned
Jan 19, 2006
Last updated
Sep 26, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05780 IA Primary

Addresses

Primary practice location

810 S Mechanic St
Decorah, IA 52101-2146

Mailing address

810 S Mechanic St
Decorah, IA 52101-2146
Phone (563) 382-3801

Other identifiers 2

IdentifierTypeStateIssuer
15201OtherWELLMARK I.D. NO.
A05780OtherIACHIROPRACTIC LICENSE NO.

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041124000940 IA Practitioner - Chiropractic 7315902749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

810 S Mechanic St
Decorah, IA 52101-2146
Phone (563) 382-3801

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A05780IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Swella Clinic of Chiropractic, P.C. Chiropractor CurrentSince Mar 4, 1994 Accepting new patients

Locations

810 S Mechanic St
Decorah, IA 52101
Phone (563) 382-3801

Organizations & group practices 1

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1811977473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 S MECHANIC ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012146",
            "telephone_number": "563-382-3801",
            "fax_number": "563-387-0004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 S MECHANIC ST",
            "city": "DECORAH",
            "state": "IA",
            "postal_code": "521012146",
            "telephone_number": "563-382-3801",
            "fax_number": "563-387-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWELLA SMEDSRUD",
        "first_name": "REBECCA",
        "middle_name": "J.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-19",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05780",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK I.D. NO.",
            "identifier": "15201",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CHIROPRACTIC LICENSE NO.",
            "identifier": "A05780",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decorah, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.