Individual provider Active NPI

Chelsea Lee Goedken, D.C.

  • Chiropractor
  • Omaha, NE
National Provider Identifier
1952675498
Registry record updated Jun 19, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007520 Issued in IA
Practice address
17117 Oak Dr
Suite C
Omaha, NE 68130-2193
Phone
(402) 991-7117
Fax
(402) 991-7177
NPI assigned
Mar 1, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 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 007520 IA Primary

Addresses

Primary practice location

17117 Oak Dr
Suite C
Omaha, NE 68130-2193

Mailing address

17117 Oak Dr
Suite C
Omaha, NE 68130-2193
Phone (402) 991-7117

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120709000059 NE Practitioner - Chiropractic 4385809862 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17117 Oak Dr
Suite C
Omaha, NE 68130-2193
Phone (402) 991-7170

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007520IAMDChiropractor
1710NEMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Back in Balance Chiropractic & Acupuncture, P.C. Chiropractor CurrentSince Jun 7, 2012 Accepting new patients

Locations

17117 Oak Dr
Ste C
Omaha, NE 68130
Phone (402) 991-7117

Organizations & group practices 1

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": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1952675498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17117 OAK DR",
            "address_2": "SUITE C",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302193",
            "telephone_number": "402-991-7117",
            "fax_number": "402-991-7177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17117 OAK DR",
            "address_2": "SUITE C",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681302193",
            "telephone_number": "402-991-7117",
            "fax_number": "402-991-7177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOEDKEN",
        "first_name": "CHELSEA",
        "middle_name": "LEE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Omaha, NE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.