Individual provider Active NPI

Tracey Lynn Drennen-Alexander, D.C.

  • Chiropractor
  • Freeburg, IL
National Provider Identifier
1063499622
Registry record updated Oct 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-009402 Issued in IL
Practice address
1002 N State St
Freeburg, IL 62243-4008
Phone
(618) 539-3333
Fax
(618) 539-2222
NPI assigned
Dec 26, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 16, 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 038-009402 IL Primary

Addresses

Primary practice location

1002 N State St
Freeburg, IL 62243-4008

Mailing address

1002 N State St
Freeburg, IL 62243-4008
Phone (618) 539-3333

Other identifiers 4

IdentifierTypeStateIssuer
473545OtherILHEALTHLINK
1030171OtherILCIGNA
157115OtherMOBC/BS OF MO
8232017OtherILBC/BS OF IL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110117000002 IL Practitioner - Chiropractic 5092904458 Practice locations: Freeburg, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1002 N State St
Freeburg, IL 62243-4008
Phone (618) 539-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009402ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Kramper Chiropractic LLC Chiropractor CurrentSince Jan 1, 2020 Accepting new patients

Locations

1002 N State St
Freeburg, IL 62243
Phone (618) 539-3333

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": "1135555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1063499622",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1002 N STATE ST",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622434008",
            "telephone_number": "618-539-3333",
            "fax_number": "618-539-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 N STATE ST",
            "city": "FREEBURG",
            "state": "IL",
            "postal_code": "622434008",
            "telephone_number": "618-539-3333",
            "fax_number": "618-539-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DRENNEN-ALEXANDER",
        "first_name": "TRACEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-26",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "473545",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1030171",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF MO",
            "identifier": "157115",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS OF IL",
            "identifier": "8232017",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Freeburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.