NPIMap

Organization Active NPI

Jerseyville Pain Management Center, S.C.

  • Chiropractor
  • Wood River, IL
National Provider Identifier
1063470524
Registry record updated Jan 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
042-618378 Issued in IL
Legal business name
JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.
Practice address
1702 Vaughn Rd
Wood River, IL 62095
Phone
(618) 259-3321
Fax
(618) 259-3324
NPI assigned
May 3, 2006
Last updated
Jan 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2014

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

Authorized official

Name
Mr. James A Briggs, D.C.
Title
Owner
Phone
(618) 259-3321

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 042-618378 IL Primary

Addresses

Primary practice location

1702 Vaughn Rd
Wood River, IL 62095

Mailing address

P.O. Box 649
Wood River, IL 62095
Phone (618) 259-3321

Other identifiers 1

IdentifierTypeStateIssuer
5933000001OtherILMEDICARE DME

National Provider Directory

National Provider Directory

Locations

903 S State St
Jerseyville, IL 62052
Phone (618) 498-8806

1702 Vaughn Rd
Wood River, IL 62095
Phone (618) 259-3321

1702 Vaughn Rd
Ste 4
Wood River, IL 62095
Phone (618) 259-3321

Practitioners & affiliated clinicians

Practitioners 16

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.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1146614400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390348800000",
    "number": "1063470524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 649",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "62095",
            "telephone_number": "618-259-3321",
            "fax_number": "618-259-3324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1702 VAUGHN RD",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "62095",
            "telephone_number": "618-259-3321",
            "fax_number": "618-259-3324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEYVILLE PAIN MANAGEMENT CENTER, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-03",
        "last_updated": "2014-01-22",
        "status": "A",
        "authorized_official_last_name": "BRIGGS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-259-3321",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "042-618378",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE DME",
            "identifier": "5933000001",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wood River, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2014; 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.