Individual provider Active NPI

Douglas D Klinkel, DC

  • Chiropractor
  • Charles City, IA
National Provider Identifier
1851471643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
04920 Issued in IA
Practice address
904 Ferguson Street
Charles City, IA 50616-2222
Phone
(641) 228-1665
Fax
(641) 228-1727
NPI assigned
Oct 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 04920 IA Primary

Addresses

Primary practice location

904 Ferguson Street
Charles City, IA 50616-2222

Mailing address

904 Ferguson Street
Charles City, IA 50616-2222
Phone (641) 228-1665

Other identifiers 1

IdentifierTypeStateIssuer
1025247MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101026000451 IA Practitioner - Chiropractic 2668665381 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

119 N Jackson St
Charles City, IA 50616-2002

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
04920IAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Breitbach Office LLC Chiropractor CurrentSince Dec 5, 2020 Accepting new patients

Locations

119 N Jackson St
Ofc Llc
Charles City, IA 50616
Phone (641) 228-1665

119 N Jackson St
Charles City, IA 50616
Phone (641) 228-1665

904 Ferguson St
Charles City, IA 50616
Phone (515) 228-1665

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851471643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "904 FERGUSON STREET",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506162222",
            "telephone_number": "641-228-1665",
            "fax_number": "641-228-1727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "904 FERGUSON STREET",
            "city": "CHARLES CITY",
            "state": "IA",
            "postal_code": "506162222",
            "telephone_number": "641-228-1665",
            "fax_number": "641-228-1727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINKEL",
        "first_name": "DOUGLAS",
        "middle_name": "D",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "04920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1025247",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charles City, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.