Individual provider Active NPI

Roger P Edkin, D.C.

  • Chiropractor
  • Cedar Rapids, IA
National Provider Identifier
1841280757
Registry record updated Aug 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
04906 Issued in IA
Practice address
3043 Center Point Rd NE
Cedar Rapids, IA 52402-4037
Phone
(319) 364-0052
Fax
(319) 364-0690
NPI assigned
Oct 24, 2005
Last updated
Aug 21, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 04906 IA Primary
Chiropractor 111N00000X 282 TN

Addresses

Primary practice location

3043 Center Point Rd NE
Cedar Rapids, IA 52402-4037

Mailing address

3043 Center Point Rd NE
Cedar Rapids, IA 52402-4037
Phone (319) 364-0052

Other identifiers 4

IdentifierTypeStateIssuer
0282301MedicaidIA
54406OtherIAAMERICAN WHOLE HEALTH
1212282MedicaidIA
21228OtherIAWELLMARK BCBS OF IOWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04906IAMDChiropractor
282TNMDChiropractor

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": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219276800000",
    "number": "1841280757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3043 CENTER POINT RD NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524024037",
            "telephone_number": "319-364-0052",
            "fax_number": "319-364-0690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3043 CENTER POINT RD NE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524024037",
            "telephone_number": "319-364-0052",
            "fax_number": "319-364-0690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDKIN",
        "first_name": "ROGER",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-24",
        "last_updated": "2008-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "04906",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "282",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0282301",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN WHOLE HEALTH",
            "identifier": "54406",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1212282",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS OF IOWA",
            "identifier": "21228",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.