Individual provider Active NPI

Paul Matthew Endriss, D.C.

  • Chiropractor
  • Clinton, IA
National Provider Identifier
1891069241
Registry record updated Mar 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007517 Issued in IA
Practice address
1608 S 19TH St
Clinton, IA 52732-6702
Phone
(563) 242-2002
Fax
(563) 242-2772
NPI assigned
Mar 2, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 2, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007517 IA Primary

Addresses

Primary practice location

1608 S 19TH St
Clinton, IA 52732-6702

Mailing address

1608 S 19TH St
Clinton, IA 52732-6702
Phone (563) 242-2002

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Muscle & Spine Chiropractic Clinic Inc Chiropractor PastSince Apr 15, 2018 Accepting new patients
Todd M Slattery P C Chiropractor Past Accepting new patients

Organizations & group practices 2

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": "1330646400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330646400000",
    "number": "1891069241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1608 S 19TH ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527326702",
            "telephone_number": "563-242-2002",
            "fax_number": "563-242-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1608 S 19TH ST",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527326702",
            "telephone_number": "563-242-2002",
            "fax_number": "563-242-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ENDRISS",
        "first_name": "PAUL",
        "middle_name": "MATTHEW",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-03-02",
        "last_updated": "2012-03-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007517",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.