Active NPI
Barbara A Mansholt, D.C.
- Chiropractor
- Davenport, IA
National Provider Identifier
1992709505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 06628
- Practice address
- 1000 Brady St
Davenport, IA 52803-5214 - Phone
- (563) 884-5801
- Fax
- (563) 884-5731
- NPI assigned
- Jun 10, 2005
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038-007740 | IL | |
| Chiropractor | 111N00000X | 06628 | IA | Primary |
Addresses
Primary practice location
1000 Brady St
Davenport, IA 52803-5214
Mailing address
1000 Brady St
Davenport, IA 52803-5214
Phone (563) 884-5801
Other practice location 1
2001 52nd Ave Ste 1
Moline, IL 61265-6368
Phone (309) 764-4901
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992709505 | Medicaid | IA | |
| 038007740 | Medicaid | IL | |
| IL0101 | Other | IL | JOHN DEERE |
| 8106816 | Other | IL | BLUE CROSS BLUE SHIELD |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038-007740 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1992709505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1000 BRADY ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528035214",
"telephone_number": "563-884-5801",
"fax_number": "563-884-5731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1000 BRADY ST",
"city": "DAVENPORT",
"state": "IA",
"postal_code": "528035214",
"telephone_number": "563-884-5801",
"fax_number": "563-884-5731"
}
],
"practiceLocations": [
{
"address_1": "2001 52nd Ave Ste 1",
"address_purpose": "LOCATION",
"city": "Moline",
"state": "IL",
"postal_code": "612656368",
"country_code": "US",
"telephone_number": "309-764-4901",
"fax_number": "309-797-7688",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MANSHOLT",
"first_name": "BARBARA",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-06-10",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038-007740",
"primary": false
},
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IA",
"license": "06628",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1992709505",
"state": "IA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "038007740",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "JOHN DEERE",
"identifier": "IL0101",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "8106816",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Davenport, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.