SG Chiropractic PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

4424 Issued in MN

Legal business name

SG CHIROPRACTIC PC

Doing business as

Advanced Body Chiropractic

Practice address

93 20TH St NE
Stewartville, MN 55976-8421

Phone

(507) 533-4777

Fax

(507) 533-4778

NPI assigned

Mar 13, 2014

Last updated

Mar 13, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Greg Lillis

Title

Business Manager

Phone

(507) 533-4777

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Advanced Body Chiropractic Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Christine Lillis, D.C.

  • Chiropractor
  • Stewartville, MN
  • NPI 1982609525
  Medicare reassignment NPD
• Lewis James Pagel, DC

  • Chiropractor
  • Kotzebue, AK
  • NPI 1497851372
  NPD (past)
• Brooke E Silberhorn, DC

  • Chiropractor
  • Roscoe, IL
  • NPI 1215159256
  NPD (past)

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

{
    "created_epoch": "1394668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1394668800000",
    "number": "1023434164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "93 20TH ST NE",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559768421",
            "telephone_number": "507-533-4777",
            "fax_number": "507-533-4778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 20TH ST NE",
            "city": "STEWARTVILLE",
            "state": "MN",
            "postal_code": "559768421",
            "telephone_number": "507-533-4777",
            "fax_number": "507-533-4778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SG CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-13",
        "last_updated": "2014-03-13",
        "status": "A",
        "authorized_official_last_name": "LILLIS",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "BUSINESS MANAGER",
        "authorized_official_telephone_number": "507-533-4777",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MN",
            "license": "4424",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3366567",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Body Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Vanessa Mae Peterson
• Gabrielle C Poller, M.S
• Rochester Medical Corporation
• Root River Dental, PA
• Kelsey Schaefer, COTA
• Snyders Drug Stores Inc (Snyder Drug Store)
• Sota Family Dentistry PLLC
• Stewartville Family Dentistry PLLC (Stewartville Family Dentistry)
• Stewartville Nursing Home, Inc.
• Elizabeth Tart, LICSW

• Chiropractor in Stewartville, MN
• Providers in Stewartville, MN by specialty
• Chiropractor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2014; 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.