Provider Demographics
NPI:1861401275
Name:APPLEWOOD CHIROPRACTIC CLINIC PC
Entity type:Organization
Organization Name:APPLEWOOD CHIROPRACTIC CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:HAPP
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:402-331-9444
Mailing Address - Street 1:4611 S 96TH ST STE 156
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1242
Mailing Address - Country:US
Mailing Address - Phone:402-331-9444
Mailing Address - Fax:402-331-4142
Practice Address - Street 1:4611 S 96TH ST STE 156
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1242
Practice Address - Country:US
Practice Address - Phone:402-331-9444
Practice Address - Fax:402-331-4142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-05
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1421111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025380600Medicaid
NEP00332063OtherRAILROAD MEDICARE
NE281015OtherCOVENTRY
NE81091OtherBLUE CROSS BLUE SHIELD
NE250784OtherMIDLANDS CHOICE
NE281015OtherCOVENTRY