Individual provider Active NPI

Sam H Terbeek, D.C.

  • Nutrition Chiropractor
  • Galesburg, IL
National Provider Identifier
1053457432
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
Practice address
2515 Grand Ave
Galesburg, IL 61401-6632
Phone
(309) 342-1717
Fax
(309) 342-7520
NPI assigned
Jan 30, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X IL Primary

Addresses

Primary practice location

2515 Grand Ave
Galesburg, IL 61401-6632

Mailing address

2515 Grand Ave
Galesburg, IL 61401-6632
Phone (309) 342-0919

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-005571ILMDNutrition Chiropractor

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053457432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 GRAND AVE",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614016632",
            "telephone_number": "309-342-0919",
            "fax_number": "309-342-7520"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 GRAND AVE",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614016632",
            "telephone_number": "309-342-1717",
            "fax_number": "309-342-7520"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TERBEEK",
        "first_name": "SAM",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.