Individual provider Active NPI

T Scott Yoder, DC, CCSP

  • Sports Physician Chiropractor
  • Lansing, IL
National Provider Identifier
1093828089
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
Practice address
18525 Torrence Ave Ste F3
Lansing, IL 60438-2891
Phone
(708) 418-5505
Fax
(708) 418-5531
NPI assigned
Aug 16, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X IL Primary

Addresses

Primary practice location

18525 Torrence Ave Ste F3
Lansing, IL 60438-2891

Mailing address

18525 Torrence Ave Ste F3
Lansing, IL 60438-2891
Phone (708) 418-5505

Other identifiers 1

IdentifierTypeStateIssuer
21622585OtherILBLUE CROSS/ BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
038-007368ILMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Suburban Chiropractic-Lansing, PC PastSince Apr 15, 1999 Accepting new patients
Suburban Chiropractic & Rehab LTD Sports Physician Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1155686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093828089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18525 TORRENCE AVE STE F3",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604382891",
            "telephone_number": "708-418-5505",
            "fax_number": "708-418-5531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18525 TORRENCE AVE STE F3",
            "city": "LANSING",
            "state": "IL",
            "postal_code": "604382891",
            "telephone_number": "708-418-5505",
            "fax_number": "708-418-5531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YODER",
        "first_name": "T",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DC, CCSP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/ BLUE SHIELD",
            "identifier": "21622585",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.