Individual provider Active NPI

Paul R Ewert, DC

  • Chiropractor
  • New Hampton, IA
National Provider Identifier
1992720643
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
AO 5459 Issued in IA
Practice address
16 N Water Avenue
New Hampton, IA 50659
Phone
(641) 394-3039
Fax
(641) 394-6221
NPI assigned
Jul 13, 2006
Sex
Male
Sole proprietor
No

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 AO 5459 IA Primary

Addresses

Primary practice location

16 N Water Avenue
New Hampton, IA 50659

Mailing address

16 N Water Avenue
New Hampton, IA 50659
Phone (641) 394-3039

Other identifiers 2

IdentifierTypeStateIssuer
28616OtherWELLMARK BCBS OF IA
286161MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050118000766 IA Practitioner - Chiropractic 0941259824 Practice locations: New Hampton, IA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

16 N Water Ave
New Hampton, IA 50659-1458
Phone (515) 394-3039

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AO 5459IAMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992720643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 N WATER AVENUE",
            "city": "NEW HAMPTON",
            "state": "IA",
            "postal_code": "50659",
            "telephone_number": "641-394-3039",
            "fax_number": "641-394-6221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 N WATER AVENUE",
            "city": "NEW HAMPTON",
            "state": "IA",
            "postal_code": "50659",
            "telephone_number": "641-394-3039",
            "fax_number": "641-394-6221"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EWERT",
        "first_name": "PAUL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "AO 5459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK BCBS OF IA",
            "identifier": "28616",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "286161",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Hampton, 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.