Individual provider Active NPI

Kelly L Helms, D.C.

  • Chiropractor
  • Mattoon, IL
National Provider Identifier
1194820985
Registry record updated Sep 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-008909 Issued in IL
Practice address
1804 Broadway Ave
Mattoon, IL 61938-3806
Phone
(217) 235-3100
Fax
(217) 235-3104
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-008909 IL Primary

Addresses

Primary practice location

1804 Broadway Ave
Mattoon, IL 61938-3806

Mailing address

1804 Broadway Ave
Mattoon, IL 61938
Phone (217) 235-3100

Other identifiers 3

IdentifierTypeStateIssuer
350049692OtherILRR MEDICARE
038008909MedicaidIL
01526215OtherILBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100511000968 IL Practitioner - Chiropractic 6507994621 Practice locations: Mattoon, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1999
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1804 Broadway Ave
Mattoon, IL 61938-3806
Phone (217) 235-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-008909ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. Donald Freesmeier 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537401600000",
    "number": "1194820985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "61938",
            "telephone_number": "217-235-3100",
            "fax_number": "217-235-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1804 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619383806",
            "telephone_number": "217-235-3100",
            "fax_number": "217-235-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HELMS",
        "first_name": "KELLY",
        "middle_name": "L",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2018-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-008909",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350049692",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038008909",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "01526215",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.