NPIMap

Organization Active NPI

Healthsource of Cedar Rapids PC

  • Chiropractor
  • Cedar Rapids, IA
National Provider Identifier
1972824738
Registry record updated Jun 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
HEALTHSOURCE OF CEDAR RAPIDS PC
Practice address
206 Collins Rd NE Ste 102
Cedar Rapids, IA 52402-3165
Phone
(319) 373-7576
NPI assigned
Jun 16, 2010
Last updated
Jun 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2010

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

Authorized official

Name
Dr. Jeffrey J Wisdo, D.C.
Title
President
Phone
(563) 508-9036

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

206 Collins Rd NE Ste 102
Cedar Rapids, IA 52402-3165

Mailing address

206 Collins Rd NE Ste 102
Cedar Rapids, IA 52402-3165
Phone (319) 373-7576

National Provider Directory

National Provider Directory

Locations

206 Collins Rd NE
Ste 102
Cedar Rapids, IA 52402
Phone (319) 373-7576

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1276646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276646400000",
    "number": "1972824738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 COLLINS RD NE STE 102",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023165",
            "telephone_number": "319-373-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 COLLINS RD NE STE 102",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524023165",
            "telephone_number": "319-373-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HEALTHSOURCE OF CEDAR RAPIDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-16",
        "last_updated": "2010-06-16",
        "status": "A",
        "authorized_official_last_name": "WISDO",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-508-9036",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2010; 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.