Individual provider Active NPI

Bobbie Lynn Whitacre, D.C.

  • Chiropractor
  • Murphysboro, IL
National Provider Identifier
1114951415
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
1200 Locust St
Murphysboro, IL 62966-2121
Phone
(618) 684-3344
Fax
(618) 684-2216
NPI assigned
Jul 10, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X MO Primary

Addresses

Primary practice location

1200 Locust St
Murphysboro, IL 62966-2121

Mailing address

7 Suburban Dr
Murphysboro, IL 62966-2938
Phone (618) 684-3344

Other identifiers 1

IdentifierTypeStateIssuer
02832006OtherILBCBS

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009433MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Corley Chiropractic and Rehab Clinic LTD 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.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114951415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7 SUBURBAN DR",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629662938",
            "telephone_number": "618-684-3344",
            "fax_number": "618-684-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 LOCUST ST",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629662121",
            "telephone_number": "618-684-3344",
            "fax_number": "618-684-2216"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITACRE",
        "first_name": "BOBBIE",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "02832006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Murphysboro, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.