Mary Lou Beach, D.C., C.C.S.P.

Primary specialty

Sports Physician ChiropractorTaxonomy code 111NS0005X

License

038-005425 Issued in IL

Practice address

409 E Front St
Bloomington, IL 61701-5309

Phone

(309) 828-3415

Fax

(309) 828-2665

NPI assigned

Sep 28, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Weiss Chiropractic Center

  • Chiropractor
  • Bloomington, IL
  • NPI 1174712061

  Sports Physician

  NPD (past) Authorized official
• Griesbaum Family Chiropractic S C

  • Chiropractor
  • Normal, IL
  • NPI 1356637938
  NPD

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317168000000",
    "number": "1013009083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "409 E FRONT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015309",
            "telephone_number": "309-828-3415",
            "fax_number": "309-828-2665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 E FRONT ST",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617015309",
            "telephone_number": "309-828-3415",
            "fax_number": "309-828-2665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEACH",
        "first_name": "MARY",
        "middle_name": "LOU",
        "name_prefix": "Dr.",
        "credential": "D.C., C.C.S.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-28",
        "last_updated": "2011-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038-005425",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melody Ann Bauman, PA-C
• Chelsey Baumann
• Desiree' Baumia
• Maris Baylor
• Nadir Baziz, APRN
• Beacon Health
• Kristy Renee Beams
• Caitlin Brooke Beard
• Danielle D Beasley
• Barbara Ann Becker, FNP-BC

• Sports Physician Chiropractor in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Sports Physician Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.