Active NPI
Demorie Raeanna Blair-Sturtevant, D.C.
- Chiropractor
- Milledgeville, IL
National Provider Identifier
1063858710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.012432
- Practice address
- 444 N Main Ave
Milledgeville, IL 61051-9506 - Phone
- (815) 855-3061
- Fax
- (815) 855-3062
- NPI assigned
- May 21, 2013
- Last updated
- Jan 9, 2018
- Sex
- Female
- 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 | 038.012432 | IL | Primary |
Addresses
Primary practice location
444 N Main Ave
Milledgeville, IL 61051-9506
Mailing address
PO Box 132
Milledgeville, IL 61051-0132
Phone (815) 855-3061
Other names 1
- Dr. Demorie Raeanna Blair
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130723000480 | IL | Practitioner - Chiropractic | 5698916302 | Practice locations: Milledgeville, IL |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.012432 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard L. Piller DC PC | Chiropractor | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Chiropractor
- Dixon, IL
- NPI 1295888469
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1369094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515456000000",
"number": "1063858710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 132",
"city": "MILLEDGEVILLE",
"state": "IL",
"postal_code": "610510132",
"telephone_number": "815-855-3061",
"fax_number": "815-855-3062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "444 N MAIN AVE",
"city": "MILLEDGEVILLE",
"state": "IL",
"postal_code": "610519506",
"telephone_number": "815-855-3061",
"fax_number": "815-855-3062"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BLAIR-STURTEVANT",
"first_name": "DEMORIE",
"middle_name": "RAEANNA",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-05-21",
"last_updated": "2018-01-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.012432",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "DEMORIE",
"last_name": "BLAIR",
"middle_name": "RAEANNA",
"prefix": "DR.",
"credential": "D.C.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Milledgeville, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2018; 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.