Quad Cities Regenerative Medicine, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

QUAD CITIES REGENERATIVE MEDICINE, LLC

Practice address

4101 John Deere Rd Ste 2
Moline, IL 61265-6790

Phone

(309) 581-2999

NPI assigned

Feb 21, 2020

Last updated

Feb 21, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Lance M Carroll, DCNPI 1861405987

Title

Manager

Phone

(309) 502-9513

Specialties & licenses 2

Addresses

Locations

Practitioners 1

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.

• Lance M. Carroll, D.C.

  • Chiropractor
  • Moline, IL
  • NPI 1861405987
  Authorized official Same address or phone

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582243200000",
    "number": "1073146692",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4101 JOHN DEERE RD STE 2",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656790",
            "telephone_number": "309-581-2999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4101 JOHN DEERE RD STE 2",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656790",
            "telephone_number": "309-581-2999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QUAD CITIES REGENERATIVE MEDICINE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A",
        "authorized_official_last_name": "CARROLL",
        "authorized_official_first_name": "LANCE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "309-502-9513",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quad Cities Kidney Center, LTD.
• Quad Cities Mental Health
• Quad Cities Nephrology Associates, P.L.C., LLC
• Quad Cities Pathologists, LLC
• Quad Cities Recovery & Counseling Center LLC
• Quad Cities Wellness and Rehabilitation Center, LTD.
• Quad Cities Wellness Clinic
• Quad City Ambulatory Surgery Center LLC
• Quad City Clinic SC
• Quad City Endoscopy, L.L.C.

• Chiropractor in Moline, IL
• Providers in Moline, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.