Individual provider Active NPI

Colin Shepherd, D.C.

  • Chiropractor
  • Mt Pleasant, IA
National Provider Identifier
1952771719
Registry record updated Oct 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
079103 Issued in IA
Practice address
107 N Main St
Mt Pleasant, IA 52641-2027
Phone
(319) 201-1900
NPI assigned
Oct 5, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 079103 IA Primary

Addresses

Primary practice location

107 N Main St
Mt Pleasant, IA 52641-2027

Mailing address

107 N Main St
Mt Pleasant, IA 52641-2027
Phone (319) 201-1900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161031001055 IA Practitioner - Chiropractic 9436437167 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 2015
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

107 N Main St
Main Street Chiro
Mt Pleasant, IA 52641-2027
Phone (319) 201-1900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Main Street Chiro, LLC Chiropractor CurrentSince Aug 15, 2022 Accepting new patients
My Chiro, L.L.C. Chiropractor CurrentSince Oct 10, 2016 Accepting new patients

Locations

3221 16th Ave SW
Cedar Rapids, IA 52404
Phone (319) 294-0000

107 N Main St
Mt Pleasant, IA 52641
Phone (319) 201-1900

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": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603152000000",
    "number": "1952771719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 N MAIN ST",
            "city": "MT PLEASANT",
            "state": "IA",
            "postal_code": "526412027",
            "telephone_number": "319-201-1900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N MAIN ST",
            "city": "MT PLEASANT",
            "state": "IA",
            "postal_code": "526412027",
            "telephone_number": "319-201-1900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEPHERD",
        "first_name": "COLIN",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-05",
        "last_updated": "2020-10-20",
        "certification_date": "2020-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "079103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mt Pleasant, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2020; 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.