Organization Active NPI

Ward Chiropractic PC

  • Chiropractor
  • Mattoon, IL
National Provider Identifier
1245311208
Registry record updated Nov 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
WARD CHIROPRACTIC PC
Practice address
1616 Lafayette Ave
Mattoon, IL 61938-3926
Phone
(217) 234-2243
Fax
(217) 234-2253
NPI assigned
Oct 18, 2006
Last updated
Nov 28, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2007

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

Authorized official

Name
Dr. Terry Allen Ward, DCNPI 1316918774
Title
President Treasurer
Phone
(217) 234-2243

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary
Acupuncturist 171100000X IL

Addresses

Primary practice location

1616 Lafayette Ave
Mattoon, IL 61938-3926

Mailing address

1616 Lafayette Ave
Mattoon, IL 61938-3926
Phone (217) 234-2243

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060424000054 IL Part B Supplier - Clinic/Group Practice 4789694639 Receives reassigned benefits from 1 practitioner
Practice locations: Mattoon, IL

National Provider Directory

National Provider Directory

Locations

1616 Lafayette Ave
Mattoon, IL 61938
Phone (217) 234-2243

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196208000000",
    "number": "1245311208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1616 LAFAYETTE AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619383926",
            "telephone_number": "217-234-2243",
            "fax_number": "217-234-2253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1616 LAFAYETTE AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619383926",
            "telephone_number": "217-234-2243",
            "fax_number": "217-234-2253"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WARD CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2007-11-28",
        "status": "A",
        "authorized_official_last_name": "WARD",
        "authorized_official_first_name": "TERRY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "PRESIDENT  TREASURER",
        "authorized_official_telephone_number": "217-234-2243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        },
        {
            "code": "171100000X",
            "taxonomy_group": "",
            "desc": "Acupuncturist",
            "state": "IL",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "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 Nov 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.