Individual provider Active NPI

Douglas George Frey, D.C.

  • Chiropractor
  • Cascade, IA
National Provider Identifier
1841314929
Registry record updated Jan 7, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06468 Issued in IA
Practice address
206 Grant St. SW
Cascade, IA 52033-0456
Phone
(563) 852-3396
Fax
(563) 852-3565
NPI assigned
Mar 16, 2007
Last updated
Jan 7, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 06468 IA Primary

Addresses

Primary practice location

206 Grant St. SW
Cascade, IA 52033-0456

Mailing address

206 Grant St. SW
Cascade, IA 52033-0456
Phone (563) 852-3396

Other identifiers 1

IdentifierTypeStateIssuer
0256768MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060503000326 IA Practitioner - Chiropractic 8224048467 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Northwestern College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

206 Grant St SW
Cascade, IA 52033-9472
Phone (563) 852-3396

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06468IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Grant Street Chiropractic PC Chiropractor CurrentSince Feb 2, 2006 Accepting new patients

Locations

206 Grant St SW
Cascade, IA 52033
Phone (563) 852-3396

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1199664000000",
    "number": "1841314929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 GRANT ST. SW",
            "city": "CASCADE",
            "state": "IA",
            "postal_code": "520330456",
            "telephone_number": "563-852-3396",
            "fax_number": "563-852-3565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 GRANT ST. SW",
            "city": "CASCADE",
            "state": "IA",
            "postal_code": "520330456",
            "telephone_number": "563-852-3396",
            "fax_number": "563-852-3565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREY",
        "first_name": "DOUGLAS",
        "middle_name": "GEORGE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2008-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06468",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0256768",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cascade, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2008; 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.