Organization Active NPI

Fread Family Chiropractic, P.C.

  • Chiropractor
  • Kearney, NE
National Provider Identifier
1922305697
Registry record updated Feb 17, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
FREAD FAMILY CHIROPRACTIC, P.C.
Practice address
5308 Parklane Dr Ste 5
Kearney, NE 68847-8629
Phone
(308) 237-0648
Fax
(308) 236-9197
NPI assigned
Feb 16, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2011

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

Authorized official

Name
Dustin Ezra Fread, D.C.NPI 1417267279
Title
Owner/President
Phone
(308) 236-0648

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

5308 Parklane Dr Ste 5
Kearney, NE 68847-8629

Mailing address

5308 Parklane Dr Ste 5
Kearney, NE 68847-8629
Phone (308) 237-0648

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110221000478 NE Part B Supplier - Clinic/Group Practice 0143401497 Receives reassigned benefits from 1 practitioner
Practice locations: Kearney, NE

National Provider Directory

National Provider Directory

Locations

220 W 42nd St
#A
Kearney, NE 68845
Phone (308) 237-0648

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1297814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297900800000",
    "number": "1922305697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 PARKLANE DR STE 5",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478629",
            "telephone_number": "308-237-0648",
            "fax_number": "308-236-9197"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5308 PARKLANE DR STE 5",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688478629",
            "telephone_number": "308-237-0648",
            "fax_number": "308-236-9197"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FREAD FAMILY CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-16",
        "last_updated": "2011-02-17",
        "status": "A",
        "authorized_official_last_name": "FREAD",
        "authorized_official_first_name": "DUSTIN",
        "authorized_official_middle_name": "EZRA",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "308-236-0648",
        "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": []
}

Other providers in Kearney, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2011; 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.