NPIMap

Organization Active NPI

Elite Health Systems Inc

  • Chiropractor
  • Bettendorf, IA
National Provider Identifier
1992256754
Registry record updated Aug 13, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
06460 Issued in IA
Legal business name
ELITE HEALTH SYSTEMS INC
Practice address
2550 Middle Rd Ste 400
Bettendorf, IA 52722
Phone
(563) 359-4203
Fax
(563) 345-4099
NPI assigned
Oct 17, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2018

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

Authorized official

Name
Jay Christopher Johannsen, DCNPI 1801867866
Title
Doctor
Phone
(563) 359-4203

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 007354 IA
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 06460 IA Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 07531 IA

Addresses

Primary practice location

2550 Middle Rd Ste 400
Bettendorf, IA 52722

Mailing address

2550 Middle Rd Ste 400
Bettendorf, IA 52722-3288
Phone (563) 359-4203

Other practice location 1

2393 Cumberland Square Dr
Bettendorf, IA 52722-3251
Phone (563) 359-4203

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170206000300 IA Part B Supplier - Clinic/Group Practice 9931482510 Receives reassigned benefits from 2 practitioners
Practice locations: Bettendorf, IA

National Provider Directory

National Provider Directory
Tax ID family
Dr J Chiropractic PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1534118400000",
    "number": "1992256754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 MIDDLE RD STE 400",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223288",
            "telephone_number": "563-359-4203",
            "fax_number": "563-345-4099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 MIDDLE RD STE 400",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "52722",
            "telephone_number": "563-359-4203",
            "fax_number": "563-345-4099"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2393 Cumberland Square Dr",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527223251",
            "country_code": "US",
            "telephone_number": "563-359-4203",
            "fax_number": "563-345-4099",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE HEALTH SYSTEMS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-17",
        "last_updated": "2018-08-13",
        "status": "A",
        "authorized_official_last_name": "JOHANNSEN",
        "authorized_official_first_name": "JAY",
        "authorized_official_middle_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "563-359-4203",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007354",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "06460",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "07531",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bettendorf, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.