Organization Active NPI

True Roots Chiropractic & Wellness PLLC

  • Chiropractor
  • Springfield, IL
National Provider Identifier
1265098636
Registry record updated Jan 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
TRUE ROOTS CHIROPRACTIC & WELLNESS PLLC
Practice address
7012 Kingsmill CT
Springfield, IL 62711-7387
Phone
(217) 679-3637
NPI assigned
May 11, 2019
Last updated
Jan 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2023

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

Authorized official

Name
Dr. Payton Jordon, DCNPI 1285199166
Title
Owner
Phone
(217) 891-4551

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 1

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

Addresses

Primary practice location

7012 Kingsmill CT
Springfield, IL 62711-7387

Mailing address

7012 Kingsmill CT
Springfield, IL 62711-7387
Phone (217) 679-3637

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220504001768 IL Part B Supplier - Clinic/Group Practice 2668704859 Receives reassigned benefits from 2 practitioners
Practice locations: Springfield, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

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": "1557532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1265098636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7012 KINGSMILL CT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117387",
            "telephone_number": "217-679-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7012 KINGSMILL CT",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627117387",
            "telephone_number": "217-679-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRUE ROOTS CHIROPRACTIC & WELLNESS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-11",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-30",
        "status": "A",
        "authorized_official_last_name": "JORDON",
        "authorized_official_first_name": "PAYTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-891-4551",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 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.