NPIMap

Organization Active NPI

Elite Chiropractic & Rehab LLC

  • Chiropractor
  • O Fallon, IL
National Provider Identifier
1174284566
Registry record updated Jan 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
ELITE CHIROPRACTIC & REHAB LLC
Practice address
9 Eagle Ctr Ste 1
O Fallon, IL 62269-1948
Phone
(208) 539-4560
NPI assigned
Jan 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2022

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

Authorized official

Name
Cody Jones, DC
Title
Owner Operator
Phone
(208) 539-4560

Specialties & licenses 1

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

Addresses

Primary practice location

9 Eagle Ctr Ste 1
O Fallon, IL 62269-1948

Mailing address

9 Eagle Ctr Ste 1
O Fallon, IL 62269-1948

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Drcody.irm@gmail.com Direct

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1641513600000",
    "number": "1174284566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 EAGLE CTR STE 1",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 EAGLE CTR STE 1",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691948",
            "telephone_number": "208-539-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE CHIROPRACTIC & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-01-07",
        "last_updated": "2022-01-07",
        "certification_date": "2022-01-07",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "CODY",
        "authorized_official_title_or_position": "OWNER OPERATOR",
        "authorized_official_telephone_number": "208-539-4560",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Drcody.irm@gmail.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "9 Eagle Ctr Ste 1",
            "city": "O Fallon",
            "state": "IL",
            "country_code": "US",
            "postal_code": "622691948",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2022; 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.