Organization Active NPI

Bemis Tupman Chiropractic LLC

  • Chiropractor
  • Alton, IL
National Provider Identifier
1003462417
Registry record updated Nov 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BEMIS TUPMAN CHIROPRACTIC LLC
Practice address
4105 Humbert Rd Ste 102
Alton, IL 62002-7161
Phone
(618) 463-1600
Fax
(618) 463-1624
NPI assigned
Aug 12, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Kristina Bemis, DCNPI 1396128807
Title
Owner
Phone
(618) 463-1600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

4105 Humbert Rd Ste 102
Alton, IL 62002-7161

Mailing address

4105 Humbert Rd Ste 102
Alton, IL 62002-7161
Phone (618) 463-1600

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191008002762 IL Part B Supplier - Clinic/Group Practice 2163753021 Receives reassigned benefits from 3 practitioners
Practice locations: Alton, IL

National Provider Directory

National Provider Directory

Locations

4105 Humbert Rd
Ste 102
Alton, IL 62002
Phone (618) 463-1600

4105 Humbert Rd
#102
Alton, IL 62002
Phone (618) 463-1600

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732060800000",
    "number": "1003462417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 HUMBERT RD STE 102",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027161",
            "telephone_number": "618-463-1600",
            "fax_number": "618-463-1624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 HUMBERT RD STE 102",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620027161",
            "telephone_number": "618-463-1600",
            "fax_number": "618-463-1624"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEMIS TUPMAN CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-12",
        "last_updated": "2024-11-20",
        "certification_date": "2024-11-20",
        "status": "A",
        "authorized_official_last_name": "BEMIS",
        "authorized_official_first_name": "KRISTINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-463-1600",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.