Individual provider Active NPI

Martie Jo Blue, DC

  • Chiropractor
  • Marion, IL
National Provider Identifier
1245286574
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
249412 Issued in KY
Practice address
302 S Market St Ste B
Marion, IL 62959-2532
Phone
(618) 964-6976
Fax
(888) 793-3309
NPI assigned
May 26, 2006
Last updated
Aug 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X DC0000001576 TN
Chiropractor 111N00000X 249412 KY Primary

Addresses

Primary practice location

302 S Market St Ste B
Marion, IL 62959-2532

Mailing address

302 S Market St Ste B
Marion, IL 62959-2532
Phone (618) 964-6976

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200617001761 IL Practitioner - Chiropractic 4789613944 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1007 /2 W Main St
Marion, IL 62959-1841
Phone (618) 964-6976

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
DC0000001576TNMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Health of Southern Illinois Chiropractor CurrentSince Jul 1, 2020 Accepting new patients
Integrated Health of Southern Illinois, LTD. Chiropractor CurrentSince Jul 1, 2020 Accepting new patients
Brown Chiropractic Chiropractor Past Accepting new patients
Spine Center Inc Chiropractor PastSince Apr 28, 2010 Accepting new patients
Advanced Chiropractic Associates, PLLC Chiropractor PastSince Sep 1, 2012 Accepting new patients
East Tennessee Neuropathy, PC PastSince Apr 1, 2013 Accepting new patients

Locations

310 W Plaza Dr
Carterville, IL 62918
Phone (618) 525-0719

303 S Commercial St
Ste 10
Harrisburg, IL 62946
Phone (618) 252-5555

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/26231/brand/1/csg/1/fhir/r4

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1148601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1245286574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 S MARKET ST STE B",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629592532",
            "telephone_number": "618-964-6976",
            "fax_number": "888-793-3309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 S MARKET ST STE B",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629592532",
            "telephone_number": "618-964-6976",
            "fax_number": "888-793-3309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLUE",
        "first_name": "MARTIE",
        "middle_name": "JO",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-26",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "DC0000001576",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "KY",
            "license": "249412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marion, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; 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.