NPIMap

Organization Active NPI

Palmer College Foundation

  • Chiropractor
  • Moline, IL
National Provider Identifier
1245365733
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PALMER COLLEGE FOUNDATION
Practice address
2001 52ND Ave
Suite 1
Moline, IL 61265-6368
Phone
(309) 764-4901
Fax
(309) 797-7688
NPI assigned
Feb 23, 2007
Last updated
Sep 1, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Authorized official

Name
Tara Schulz
Title
Exec Director of Clinic Operations
Phone
(563) 884-5828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

2001 52ND Ave
Suite 1
Moline, IL 61265-6368

Mailing address

2001 52ND Ave
Suite 1
Moline, IL 61265-6368
Phone (309) 764-4901

Other identifiers 6

IdentifierTypeStateIssuer
038005059MedicaidIL
038003364MedicaidIL
038008298MedicaidIL
0008115279OtherILBLUE CROSS BLUE SHIELD IL
038003521MedicaidIL
038009444MedicaidIL

Other names 1

  • Palmer College of Chiropractic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031201000297 IL Part B Supplier - Clinic/Group Practice 1557266863 Receives reassigned benefits from 5 practitioners
Practice locations: Moline, IL

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Palmer Chiropractic Cli3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 5

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": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693526400000",
    "number": "1245365733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 52ND AVE",
            "address_2": "SUITE 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656368",
            "telephone_number": "309-764-4901",
            "fax_number": "309-797-7688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 52ND AVE",
            "address_2": "SUITE 1",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656368",
            "telephone_number": "309-764-4901",
            "fax_number": "309-797-7688"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PALMER COLLEGE FOUNDATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A",
        "authorized_official_last_name": "SCHULZ",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "EXEC DIRECTOR OF CLINIC OPERATIONS",
        "authorized_official_telephone_number": "563-884-5828"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038005059",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038003364",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038008298",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "0008115279",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038003521",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038009444",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Palmer College of Chiropractic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Palmer College of Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2023; 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.