NPIMap

Organization Active NPI

Angela Baxter LLC

  • Chiropractor
  • Herrin, IL
National Provider Identifier
1265637755
Registry record updated Sep 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010854 Issued in IL
Legal business name
ANGELA BAXTER LLC
Practice address
3313 Patriot Court
Herrin, IL 62948-3782
Phone
(618) 993-9910
Fax
(618) 993-2774
NPI assigned
Jun 15, 2007
Last updated
Sep 20, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2012

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

Authorized official

Name
Dr. Angela Louise Baxter, D.C.NPI 1881743169
Title
Owner
Phone
(618) 993-9910

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 038010854 IL Primary

Addresses

Primary practice location

3313 Patriot Court
Herrin, IL 62948-3782

Mailing address

3313 Patriot Court
Herrin, IL 62948-3782
Phone (618) 993-9910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070619000262 IL Part B Supplier - Clinic/Group Practice 1850490707 Receives reassigned benefits from 3 practitioners
Practice locations: Herrin, IL

National Provider Directory

National Provider Directory

Locations

3313 Patriot Ct
Herrin, IL 62948
Phone (618) 993-9910

Practitioners & affiliated clinicians

Practitioners 14

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 14

NPI Registry JSON

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

{
    "created_epoch": "1181865600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348099200000",
    "number": "1265637755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3313 PATRIOT COURT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483782",
            "telephone_number": "618-993-9910",
            "fax_number": "618-993-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 PATRIOT COURT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483782",
            "telephone_number": "618-993-9910",
            "fax_number": "618-993-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANGELA BAXTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-15",
        "last_updated": "2012-09-20",
        "status": "A",
        "authorized_official_last_name": "BAXTER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "LOUISE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-993-9910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010854",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; 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.