Individual provider Active NPI

Justin J Pals, D.C.

  • Chiropractor
  • Effingham, IL
National Provider Identifier
1245305366
Registry record updated Sep 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010081 Issued in IL
Practice address
401 N Keller Dr
Suite 2
Effingham, IL 62401-1881
Phone
(217) 342-3384
Fax
(217) 342-3385
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010081 IL Primary

Addresses

Primary practice location

401 N Keller Dr
Suite 2
Effingham, IL 62401-1881

Mailing address

401 N Keller Dr
Effingham, IL 62401-1881
Phone (217) 342-3384

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040424000036 IL Practitioner - Chiropractic 2264428101 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2003
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

415 W Virginia Ave
Effingham, IL 62401-2259
Phone (217) 342-3384

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010081ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
New Health Inc Chiropractor CurrentSince Jun 12, 2013 Accepting new patients
Pals Family Chiropractic Chiropractor Past Accepting new patients

Locations

415 W Virginia Ave
Effingham, IL 62401
Phone (217) 342-3384

401 N Keller Dr
Ste 2
Effingham, IL 62401
Phone (217) 342-3384

Organizations & group practices 2

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": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1315008000000",
    "number": "1245305366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 N KELLER DR",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011881",
            "telephone_number": "217-342-3384",
            "fax_number": "217-342-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 N KELLER DR",
            "address_2": "SUITE 2",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624011881",
            "telephone_number": "217-342-3384",
            "fax_number": "217-342-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALS",
        "first_name": "JUSTIN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2011-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010081",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2011; 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.