Incline Village Chiropractic LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INCLINE VILLAGE CHIROPRACTIC LLC

Practice address

894 Southwood Blvd
Incline VLG, NV 89451-9435

Phone

(775) 831-5544

Fax

(775) 831-5545

NPI assigned

Feb 25, 2020

Organization subpart

No

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

Authorized official

Name

Emma Genevieve Freeze, D.CNPI 1871287631

Title

Authorized Offifical

Phone

(775) 831-5544

Specialties & licenses 1

Addresses

Other names 1

• Incline Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in NV

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emma Genevieve Freeze, DC

  • Chiropractor
  • Incline Village, NV
  • NPI 1871287631
  Medicare reassignment Care Compare group NPD Authorized official
• Amy Catherine Vevoda, D.C.

  • Chiropractor
  • Mammoth Lakes, CA
  • NPI 1740209931

  NV

  Medicare reassignment Care Compare group NPD
• Jonathan Malley, DC

  • Chiropractor
  • Incline Village, NV
  • NPI 1902429384
  Medicare reassignment NPD
• Rodney Scott Shoemaker, DC

  • Chiropractor
  • Incline Village, NV
  • NPI 1063470128
  NPD (past)

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

{
    "created_epoch": "1582588800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1851925226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "894 SOUTHWOOD BLVD",
            "city": "INCLINE VLG",
            "state": "NV",
            "postal_code": "894519435",
            "telephone_number": "775-831-5544",
            "fax_number": "775-831-5545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "894 SOUTHWOOD BLVD",
            "city": "INCLINE VLG",
            "state": "NV",
            "postal_code": "894519435",
            "telephone_number": "775-831-5544",
            "fax_number": "775-831-5545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INCLINE VILLAGE CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-25",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "FREEZE",
        "authorized_official_first_name": "EMMA",
        "authorized_official_middle_name": "GENEVIEVE",
        "authorized_official_title_or_position": "AUTHORIZED OFFIFICAL",
        "authorized_official_telephone_number": "775-831-5544",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Incline Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

Verify at the official NPI Registry.