Organization Active NPI

Sequoia Chiropractic Inc

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1114093689
Registry record updated Apr 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009678 Issued in IL
Legal business name
SEQUOIA CHIROPRACTIC INC
Practice address
8305 N. Allen Road
Suite 7
Peoria, IL 61615-1815
Phone
(309) 692-2121
Fax
(309) 692-4747
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2009

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

Authorized official

Name
Dr. Jeremiah J. Thompson, DC
Title
Owner
Phone
(309) 692-2121

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038009678 IL Primary

Addresses

Primary practice location

8305 N. Allen Road
Suite 7
Peoria, IL 61615-1815

Mailing address

8305 N. Allen Road
Suite 7
Peoria, IL 61615-1815
Phone (309) 692-2121

Other identifiers 1

IdentifierTypeStateIssuer
7232024OtherILBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240358400000",
    "number": "1114093689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8305 N. ALLEN ROAD",
            "address_2": "SUITE 7",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151815",
            "telephone_number": "309-692-2121",
            "fax_number": "309-692-4747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8305 N. ALLEN ROAD",
            "address_2": "SUITE 7",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616151815",
            "telephone_number": "309-692-2121",
            "fax_number": "309-692-4747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SEQUOIA CHIROPRACTIC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2009-04-22",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "JEREMIAH",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-692-2121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038009678",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "7232024",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2009; 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.