Active NPI
Mariah Fillenworth
- Chiropractor
- Coralville, IA
National Provider Identifier
1851142053
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 125448
- Practice address
- 850 22ND Ave Ste 3
Coralville, IA 52241-1688 - Phone
- (319) 358-8999
- NPI assigned
- Mar 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 125448 | IA | Primary |
Addresses
Primary practice location
850 22ND Ave Ste 3
Coralville, IA 52241-1688
Mailing address
850 22ND Ave Ste 3
Coralville, IA 52241-1688
Phone (319) 358-8999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20240911000474 | IA | Practitioner - Chiropractic | 3173063633 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 125448 | IA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1711497600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713744000000",
"number": "1851142053",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "850 22ND AVE STE 3",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522411688",
"telephone_number": "319-358-8999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "850 22ND AVE STE 3",
"city": "CORALVILLE",
"state": "IA",
"postal_code": "522411688",
"telephone_number": "319-358-8999"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FILLENWORTH",
"first_name": "MARIAH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-03-27",
"last_updated": "2024-04-22",
"certification_date": "2024-04-22",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "125448",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Coralville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.