NPIMap

Organization Active NPI

Galesburg Wellness Systems P.C.

Doing business as Galesburg Wellness Center

  • Chiropractor
  • Galesburg, IL
National Provider Identifier
1255813770
Registry record updated Aug 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GALESBURG WELLNESS SYSTEMS P.C.
Doing business as
Galesburg Wellness Center
Practice address
575 N Kellogg St Ste 2
Galesburg, IL 61401-7609
Phone
(563) 344-4778
Fax
(563) 344-3914
NPI assigned
Aug 31, 2018
Last updated
Aug 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2018

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

Authorized official

Name
Jodi Marlowe
Title
Accounts Administrator
Phone
(563) 359-9541

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

575 N Kellogg St Ste 2
Galesburg, IL 61401-7609

Mailing address

2377 Cumberland Square Dr
Bettendorf, IA 52722-3251
Phone (563) 359-9541

Other names 1

  • Galesburg Wellness Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181023002525 IL Part B Supplier - Clinic/Group Practice 2668725599 Receives reassigned benefits from 2 practitioners
Practice locations: Galesburg, IL

National Provider Directory

National Provider Directory

Locations

575 N Kellogg St
Ste 2
Galesburg, IL 61401
Phone (309) 343-0160

Practitioners & affiliated clinicians

Practitioners 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1535673600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1535673600000",
    "number": "1255813770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2377 CUMBERLAND SQUARE DR",
            "city": "BETTENDORF",
            "state": "IA",
            "postal_code": "527223251",
            "telephone_number": "563-359-9541",
            "fax_number": "563-344-3914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "575 N KELLOGG ST STE 2",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614017609",
            "telephone_number": "563-344-4778",
            "fax_number": "563-344-3914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GALESBURG WELLNESS SYSTEMS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-31",
        "last_updated": "2018-08-31",
        "status": "A",
        "authorized_official_last_name": "MARLOWE",
        "authorized_official_first_name": "JODI",
        "authorized_official_title_or_position": "ACCOUNTS ADMINISTRATOR",
        "authorized_official_telephone_number": "563-359-9541"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Galesburg Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Galesburg Wellness Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Galesburg, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2018; 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.