Individual provider Active NPI

Michael Eugene Crowley, D. C.

  • Chiropractor
  • Humboldt, IA
National Provider Identifier
1982645164
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05718 Issued in IA
Practice address
611 1St Ave N
Humboldt, IA 50548-1713
Phone
(515) 332-5414
Fax
(515) 332-5415
NPI assigned
Jun 9, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X A05718 IA Primary

Addresses

Primary practice location

611 1St Ave N
Humboldt, IA 50548-1713

Mailing address

611 1St Ave N
P. O. Box 56
Humboldt, IA 50548-1713
Phone (515) 332-5414

Other identifiers 1

IdentifierTypeStateIssuer
0279810MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20111201000043 IA Practitioner - Chiropractic 5092800730 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

611 1St Ave N
Humboldt, IA 50548-1713
Phone (515) 332-5414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
1St Avenue Chiropractic, P.C. CurrentSince Sep 12, 2002 Accepting new patients

Locations

611 1st Ave N
Humboldt, IA 50548
Phone (515) 207-9899

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": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982645164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 1ST AVE N",
            "address_2": "P. O. BOX 56",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505481713",
            "telephone_number": "515-332-5414",
            "fax_number": "515-332-5415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 1ST AVE N",
            "city": "HUMBOLDT",
            "state": "IA",
            "postal_code": "505481713",
            "telephone_number": "515-332-5414",
            "fax_number": "515-332-5415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CROWLEY",
        "first_name": "MICHAEL",
        "middle_name": "EUGENE",
        "name_prefix": "Dr.",
        "credential": "D. C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05718",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0279810",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Humboldt, 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.
  • 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.