Jeanne Renee Staudt, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

A05231 Issued in IA

Practice address

133 W Main Ave
Rockford, IA 50468-7719

Phone

(641) 756-3740

Fax

(641) 756-3722

NPI assigned

Jun 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1986

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Prairieland Chiropractic P C

  • Chiropractor
  • Rockford, IA
  • NPI 1235489048
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1343606400000",
    "number": "1821039942",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 W MAIN AVE",
            "address_2": "P.O. BOX 575",
            "city": "ROCKFORD",
            "state": "IA",
            "postal_code": "504687719",
            "telephone_number": "641-756-3740",
            "fax_number": "641-756-3722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 W MAIN AVE",
            "city": "ROCKFORD",
            "state": "IA",
            "postal_code": "504687719",
            "telephone_number": "641-756-3740",
            "fax_number": "641-756-3722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STAUDT",
        "first_name": "JEANNE",
        "middle_name": "RENEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-09",
        "last_updated": "2012-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05231",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER NUMBER",
            "identifier": "41891",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1242305",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA PROV. NUMBER",
            "identifier": "P00070391",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael C Lindstrom, DO
• North Iowa Mercy Clinics
• Prairieland Chiropractic P C
• Rudd Rockford Marble Rock
• Mary Ann Shaw, ARNP

• All providers in Rockford, IA
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.