Individual provider Active NPI

Kathleen McAuliffe, DC

  • Chiropractor
  • Columbia, IL
National Provider Identifier
1043319015
Registry record updated Apr 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038004362 Issued in IL
Practice address
109 Wedgewood Drive
Columbia, IL 62236
Phone
(618) 281-7171
Fax
(618) 281-7666
NPI assigned
Sep 22, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038004362 IL Primary

Addresses

Primary practice location

109 Wedgewood Drive
Columbia, IL 62236

Mailing address

109 Wedgewood Drive
Columbia, IL 62236
Phone (618) 281-7171

Other identifiers 1

IdentifierTypeStateIssuer
038004362MedicaidIL

Other names 1

  • Dr. Kathleen Mestdagh Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050527000575 IL Practitioner - Chiropractic 2466493317 Reassigns benefits to 1 organization
Practice locations: Columbia, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
National College of Chiropractic, 1981
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

109 Wedgewood Dr
Columbia, IL 62236-1016
Phone (618) 281-7171

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McAuliffe Chiropractic, LLC Chiropractor CurrentSince Sep 1, 2019 Accepting new patients

Locations

109 Wedgewood Dr
Columbia, IL 62236
Phone (618) 281-7171

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554163200000",
    "number": "1043319015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 WEDGEWOOD DRIVE",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "62236",
            "telephone_number": "618-281-7171",
            "fax_number": "618-281-7666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 WEDGEWOOD DRIVE",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "62236",
            "telephone_number": "618-281-7171",
            "fax_number": "618-281-7666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCAULIFFE",
        "first_name": "KATHLEEN",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-22",
        "last_updated": "2019-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038004362",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KATHLEEN",
            "last_name": "MESTDAGH",
            "prefix": "DR.",
            "credential": "DC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Columbia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.