Individual provider Active NPI

Derek Brian King, D.C.

  • Chiropractor
  • Macomb, IL
National Provider Identifier
1255661609
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011583 Issued in IL
Practice address
227 S Randolph St
Macomb, IL 61455-2209
Phone
(309) 837-6932
Fax
(309) 837-3106
NPI assigned
Jan 7, 2010
Last updated
Dec 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011583 IL
Chiropractor 111N00000X 038.011583 IL Primary

Addresses

Primary practice location

227 S Randolph St
Macomb, IL 61455-2209

Mailing address

227 S Randolph St
Macomb, IL 61455-2209
Phone (309) 837-6932

Other practice location 1

448 Cole St
Bushnell, IL 61422-1540
Phone (309) 837-6932

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100610001104 IL Practitioner - Chiropractic 2961532353 Practice locations: Macomb, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

227 S Randolph St
Macomb, IL 61455-2209
Phone (309) 837-6932

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011583ILMDChiropractor
038011583ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mitch and Chris Standard Inc. CurrentSince Dec 31, 2023 Accepting new patients

Locations

227 S Randolph St
Macomb, IL 61455
Phone (309) 836-5031

Organizations & group practices 1

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": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1255661609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 S RANDOLPH ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552209",
            "telephone_number": "309-837-6932",
            "fax_number": "309-837-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 S RANDOLPH ST",
            "city": "MACOMB",
            "state": "IL",
            "postal_code": "614552209",
            "telephone_number": "309-837-6932",
            "fax_number": "309-837-3106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "448 Cole St",
            "address_purpose": "LOCATION",
            "city": "Bushnell",
            "state": "IL",
            "postal_code": "614221540",
            "country_code": "US",
            "telephone_number": "309-837-6932",
            "fax_number": "309-837-3106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KING",
        "first_name": "DEREK",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-01-07",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011583",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011583",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macomb, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2025; 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.