1730299025 NPI number — BART CHIROPRACTIC PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730299025 NPI number — BART CHIROPRACTIC PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BART CHIROPRACTIC PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1730299025
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/02/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
910 EAST PARK STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHELDON
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
51201-1275
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
712-324-4994
Provider Business Mailing Address Fax Number:
712-324-3710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
910 EAST PARK STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHELDON
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
51201-1275
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
712-324-4994
Provider Business Practice Location Address Fax Number:
712-324-3710
Provider Enumeration Date:
08/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BART
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
J
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
712-324-4994

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  A05481 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 21568 . This is a "SIOUX VALLEY HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: C05481 . This is a "DAKOTA CARE DESIGN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2294553 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7262 . This is a "MIDLANDS CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9204458 . This is a "DAKOTA CARE DESIGN GRP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 58536 . This is a "WELLMARK BLUE CROSS" identifier , issued by the state of ( IA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com