Kleckner Chiropractic Clinic P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

06264 Issued in IA

Legal business name

KLECKNER CHIROPRACTIC CLINIC P.C.

Practice address

250 SW 1St St Ste C
Grimes, IA 50111-2138

Phone

(515) 986-2233

Fax

(515) 986-0041

NPI assigned

Oct 4, 2006

Last updated

Aug 29, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Ethan John Kleckner, D.C.NPI 1710072848

Title

Doctor/Owner

Phone

(515) 986-2233

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in IA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ethan John Kleckner, D.C.

  • Chiropractor
  • Grimes, IA
  • NPI 1710072848
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1377734400000",
    "number": "1881789931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 1ST ST",
            "address_2": "SUITE C",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501112138",
            "telephone_number": "515-986-2233",
            "fax_number": "515-986-0041"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 SW 1ST ST STE C",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501112138",
            "telephone_number": "515-986-2233",
            "fax_number": "515-986-0041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KLECKNER CHIROPRACTIC CLINIC P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2013-08-29",
        "status": "A",
        "authorized_official_last_name": "KLECKNER",
        "authorized_official_first_name": "ETHAN",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "515-986-2233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS NUMBER",
            "identifier": "09304",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0205567",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "350048034",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kaizen Health and Wellness PLLC
• Sharanjeet Kaur
• KB Counseling
• Nermina Kekic
• Tiffany Ketcham, DO
• Ethan John Kleckner, D.C.
• Kurt J Klise, MD
• Amy Kritenbrink
• Adam Krug
• Samuel Lahr, DC

• Chiropractor in Grimes, IA
• Providers in Grimes, IA by specialty
• Chiropractor in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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.