Mitchellville Family Chiropractic P. C.
Organization Active NPI Chiropractor · Mitchellville, IA
NPI 1972880698 · NPPES record last updated Feb 2, 2012
Key facts
- NPI
- 1972880698
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- MITCHELLVILLE FAMILY CHIROPRACTIC P. C.
- Practice address
- 301 Center Ave S
Mitchellville, IA 50169-9751 - Phone
- (712) 790-1094
- NPI assigned
- Nov 9, 2011
- Organization subpart
- No
Authorized official
- Name
- Jason Mooney
- Title
- Owner
- Phone
- (712) 790-1094
Practitioners 2
-
Jason Mooney, D.C.
-
Laura Mooney, DC
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2311579 | Mitchellville Family Chiropractic | Certificate of waiver | Sep 23, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20120201000983 | IA | Part B Supplier - Clinic/Group Practice | 3375700438 |
Receives reassigned benefits from 2 practitioners Practice locations: Mitchellville, IA |
National Provider Directory
Locations
301 Center Ave S
Mitchellville, IA 50169
Phone (515) 967-2700
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
301 Center Ave S
Mitchellville, IA 50169-9751
Mailing address
301 Center Ave S
Mitchellville, IA 50169-9751
Other providers in Mitchellville, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.