NPIMap

Organization Active NPI

Green Chiropractic PC

  • Chiropractor
  • Galena, IL
National Provider Identifier
1265714307
Registry record updated Sep 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011965 Issued in IL
Legal business name
GREEN CHIROPRACTIC PC
Practice address
400 Broadway St
Galena, IL 61036
Phone
(815) 777-0042
NPI assigned
Sep 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2011

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

Authorized official

Name
Dr. Jason M Green, D.C.
Title
President
Phone
(563) 209-8583

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038011965 IL Primary

Addresses

Primary practice location

400 Broadway St
Galena, IL 61036

Mailing address

1736 Hwy 80 S.
Cuba City, WI 53807

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.

NPI Registry JSON

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

{
    "created_epoch": "1315958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315958400000",
    "number": "1265714307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1736 HWY 80 S.",
            "city": "CUBA CITY",
            "state": "WI",
            "postal_code": "53807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BROADWAY ST",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "61036",
            "telephone_number": "815-777-0042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREEN CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-14",
        "last_updated": "2011-09-14",
        "status": "A",
        "authorized_official_last_name": "GREEN",
        "authorized_official_first_name": "JASON",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "563-209-8583",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011965",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Galena, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.