Gary Lane Benedict, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

112 N Main St
Marissa, IL 62257-1342

Phone

(618) 295-2268

NPI assigned

Mar 9, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern Illinois Spine & Joint Center, LLC

  • Chiropractor
  • Sparta, IL
  • NPI 1013098854
  NPD

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

{
    "created_epoch": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235261066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 N MAIN ST",
            "city": "MARISSA",
            "state": "IL",
            "postal_code": "622571342",
            "telephone_number": "618-295-2268"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 N MAIN ST",
            "city": "MARISSA",
            "state": "IL",
            "postal_code": "622571342",
            "telephone_number": "618-295-2268"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BENEDICT",
        "first_name": "GARY",
        "middle_name": "LANE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin R Behn, D.M.D., P.C.
• Delbert Arthur Bollmann, RPH
• Steven Earl Dorf, D.M.D.
• Dillon Lee Kaesberg, D.C.
• Marissa Community Unit School District 40
• Marissa Food Mart (DBA Marissa Discount Pharmacy)

• Chiropractor in Marissa, IL
• Providers in Marissa, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.