Individual provider Active NPI

Thomas Joesph Holub, D.C.

  • Chiropractor
  • North Liberty, IA
National Provider Identifier
1992725618
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
A05492 Issued in IA
Practice address
430 N Dubuque St
North Liberty, IA 52317-9322
Phone
(319) 626-6800
Fax
(319) 626-3830
NPI assigned
Jul 19, 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 A05492 IA Primary

Addresses

Primary practice location

430 N Dubuque St
North Liberty, IA 52317-9322

Mailing address

430 N Dubuque St
North Liberty, IA 52317-9322
Phone (319) 626-6800

Other identifiers 1

IdentifierTypeStateIssuer
2068585MedicaidIA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050511000695 IA Practitioner - Chiropractic 6800836602 Reassigns benefits to 1 organization

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)

580 N Madison Ave
Unit 6
North Liberty, IA 52317-8402
Phone (319) 626-6800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
A05492IAMDChiropractor

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": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992725618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N DUBUQUE ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179322",
            "telephone_number": "319-626-6800",
            "fax_number": "319-626-3830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N DUBUQUE ST",
            "city": "NORTH LIBERTY",
            "state": "IA",
            "postal_code": "523179322",
            "telephone_number": "319-626-6800",
            "fax_number": "319-626-3830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLUB",
        "first_name": "THOMAS",
        "middle_name": "JOESPH",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "A05492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2068585",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in North Liberty, 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.