Individual provider Active NPI

Matthew Ryan Howard, D.C.

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1053636662
Registry record updated Jan 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011668 Issued in IL
Practice address
5901 N Prospect Rd
Suite 101
Peoria, IL 61614-4358
Phone
(309) 691-9355
Fax
(309) 691-9357
NPI assigned
Apr 7, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 31, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011668 IL Primary

Addresses

Primary practice location

5901 N Prospect Rd
Suite 101
Peoria, IL 61614-4358

Mailing address

719 W Lake Ave
Peoria, IL 61614-5941
Phone (309) 691-9355

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100817000651 IL Practitioner - Chiropractic 1759415433 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Natural Balance Wellness CenterGroup PAC ID 5991941304, 2 clinicians

Practice addresses (Care Compare)

719 W Lake Ave
Peoria, IL 61614-5941
Phone (309) 691-9355

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Natural Balance Wellness Center Chiropractor CurrentSince Dec 30, 2012 Accepting new patients

Locations

719 W Lake Ave
Peoria, IL 61614
Phone (309) 408-1493

5901 N Prospect Rd
Ste 101A
Peoria, IL 61614
Phone (309) 691-9355

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": "1270598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517356800000",
    "number": "1053636662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "719 W LAKE AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145941",
            "telephone_number": "309-691-9355",
            "fax_number": "309-691-9357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 N PROSPECT RD",
            "address_2": "SUITE 101",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616144358",
            "telephone_number": "309-691-9355",
            "fax_number": "309-691-9357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOWARD",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-04-07",
        "last_updated": "2018-01-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2018; 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.