Provider Demographics
NPI:1932179470
Name:MERRITT, JODIE LYNN (DC)
Entity type:Individual
Prefix:DR
First Name:JODIE
Middle Name:LYNN
Last Name:MERRITT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:JODIE
Other - Middle Name:LYNN
Other - Last Name:LUDWIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:626 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ANAMOSA
Mailing Address - State:IA
Mailing Address - Zip Code:52205-1634
Mailing Address - Country:US
Mailing Address - Phone:319-462-3423
Mailing Address - Fax:319-462-4360
Practice Address - Street 1:626 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ANAMOSA
Practice Address - State:IA
Practice Address - Zip Code:52205-1634
Practice Address - Country:US
Practice Address - Phone:319-462-3423
Practice Address - Fax:319-462-4360
Is Sole Proprietor?:No
Enumeration Date:2006-01-26
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA74-3041772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36486OtherBLUE CROSS BLUE SHEILD
IA237513OtherMIDLANDS CHOICE
IAI12955Medicare ID - Type Unspecified
IA36486OtherBLUE CROSS BLUE SHEILD