Mt Vernon Spine and Disc Center, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

MT VERNON SPINE AND DISC CENTER, LLC

Practice address

1009 S 42ND St Ste 2B
Mount Vernon, IL 62864-6218

Phone

(618) 713-6800

NPI assigned

Aug 10, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kenton John McMahon, D.C.

Title

Doctor/Owner

Phone

(618) 713-6800

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Kent McMahon, D.C.

  • Chiropractor
  • Mount Vernon, IL
  • NPI 1407189434
  Medicare reassignment NPD

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

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312934400000",
    "number": "1164701967",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1009 S 42ND ST STE 2B",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646218",
            "telephone_number": "618-713-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1009 S 42ND ST STE 2B",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628646218",
            "telephone_number": "618-713-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MT VERNON SPINE AND DISC CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-08-10",
        "status": "A",
        "authorized_official_last_name": "MCMAHON",
        "authorized_official_first_name": "KENTON",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "DOCTOR/OWNER",
        "authorized_official_telephone_number": "618-713-6800",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mt Vernon Community Pharmacy Inc
• Mt Vernon Cty SCH Dist 80
• Mt Vernon Family Practice PC
• Mt Vernon Neurology, S.C.
• Mt Vernon Radiation Therapy Center
• Mt Vernon TWP HS Dist 201
• Mt. Vernon Chiropractic Clinic, PLLC
• Mt. Vernon Eye Clinic, PLLC
• Mt. Vernon OB-GYN LLC
• Jason Mulholland, MS, ATC, CSCS

• Chiropractor in Mount Vernon, IL
• Providers in Mount Vernon, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2011; 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.

Verify at the official NPI Registry.