NPIMap

Organization Active NPI

Pridemore Chiropractic Center, Inc

  • Chiropractor
  • Macomb, IL
National Provider Identifier
1215010673
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038009915
Legal business name
PRIDEMORE CHIROPRACTIC CENTER, INC
Practice address
112 N Scotland St
Macomb, IL 61455-2535
Phone
(309) 837-6555
NPI assigned
Oct 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Authorized official

Name
Dr. Thomas Jefferson Pridemore Jr., D.C.NPI 1861575227
Title
President
Phone
(309) 837-6555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038009915 Primary

Addresses

Primary practice location

112 N Scotland St
Macomb, IL 61455-2535

Mailing address

PO Box 893
Macomb, IL 61455-0893
Phone (309) 837-6555

National Provider Directory

National Provider Directory

Locations

112 N Scotland St
Macomb, IL 61455
Phone (309) 836-8114

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": "1161388800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1265241600000",
    "number": "1215010673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 893",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614550893",
            "telephone_number": "309-837-6555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N SCOTLAND ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552535",
            "telephone_number": "309-837-6555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDEMORE CHIROPRACTIC CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-21",
        "last_updated": "2010-02-04",
        "status": "A",
        "authorized_official_last_name": "PRIDEMORE",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "JEFFERSON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-837-6555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": "038009915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2010; 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.