Active NPI
Nicole Anne Fitzgerald, D.C.
- Chiropractor
- Des Moines, IA
National Provider Identifier
1942322565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 06770
- Practice address
- 4520 Douglas Ave
Des Moines, IA 50310-2710 - Phone
- (515) 276-2263
- Fax
- (515) 251-2969
- NPI assigned
- Apr 4, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 06770 | IA | Primary |
Addresses
Primary practice location
4520 Douglas Ave
Des Moines, IA 50310-2710
Mailing address
4520 Douglas Ave
Des Moines, IA 50310-2710
Phone (515) 276-2263
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0466979 | Medicaid | IA | |
| 38636 | Other | IA | WELLMARK BCBS PROVIDER ID |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 06770 | IA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1942322565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4520 DOUGLAS AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503102710",
"telephone_number": "515-276-2263",
"fax_number": "515-251-2969"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4520 DOUGLAS AVE",
"city": "DES MOINES",
"state": "IA",
"postal_code": "503102710",
"telephone_number": "515-276-2263",
"fax_number": "515-251-2969"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "NICOLE",
"middle_name": "ANNE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "06770",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0466979",
"state": "IA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WELLMARK BCBS PROVIDER ID",
"identifier": "38636",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Des Moines, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.