Active NPI
Ronnie B Woods Jr., D.C.
- Chiropractor
- Mount Morris, IL
National Provider Identifier
1063646883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038011417
- Practice address
- 4167 W Mud Creek Rd
Mount Morris, IL 61054-9523 - Phone
- (815) 734-7000
- Fax
- (815) 734-7009
- NPI assigned
- May 7, 2009
- Last updated
- May 7, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038011417 | IL | Primary |
Addresses
Primary practice location
4167 W Mud Creek Rd
Mount Morris, IL 61054-9523
Mailing address
4167 W Mud Creek Rd
Mount Morris, IL 61054-9523
Phone (815) 734-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20090729000899 | IL | Practitioner - Chiropractic | 8628127446 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1241654400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1241654400000",
"number": "1063646883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4167 W MUD CREEK RD",
"city": "MOUNT MORRIS",
"state": "IL",
"postal_code": "610549523",
"telephone_number": "815-734-7000",
"fax_number": "815-734-7009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4167 W MUD CREEK RD",
"city": "MOUNT MORRIS",
"state": "IL",
"postal_code": "610549523",
"telephone_number": "815-734-7000",
"fax_number": "815-734-7009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOODS",
"first_name": "RONNIE",
"middle_name": "B",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-05-07",
"last_updated": "2009-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038011417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mount Morris, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.