Individual provider Active NPI

Kelly L Stanfield, D.C.

  • Chiropractor
  • Effingham, IL
National Provider Identifier
1285670034
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
414 W Jefferson Ave
Effingham, IL 62401-2336
Phone
(217) 342-7222
Fax
(217) 342-7214
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

414 W Jefferson Ave
Effingham, IL 62401-2336

Mailing address

414 W Jefferson Ave
Effingham, IL 62401-2336
Phone (217) 342-7222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170629002820 IL Practitioner - Chiropractic 4789699125 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Nashville Chiropractic LLCGroup PAC ID 4183718620, 2 clinicians

Practice addresses (Care Compare)

140 S Mill St
Nashville, IL 62263-1831
Phone (618) 327-2000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-007105ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Salem Chiropractic LLC Chiropractor CurrentSince Apr 14, 2023 Accepting new patients
Nashville Chiropractic, LLC Chiropractor CurrentSince Apr 30, 2018 Accepting new patients
Wood River Chiropractic, LLC Chiropractor CurrentSince Feb 6, 2017 Accepting new patients
Vincent Chiropractic, S.C. Chiropractor PastSince Apr 14, 2023 Accepting new patients

Locations

140 S Mill St
Nashville, IL 62263
Phone (618) 327-2000

120 S Delmar Ave
Ste B
Salem, IL 62881
Phone (618) 401-7117

633 Wesley Dr
Wood River, IL 62095
Phone (618) 254-9355

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285670034",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 W JEFFERSON AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012336",
            "telephone_number": "217-342-7222",
            "fax_number": "217-342-7214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 W JEFFERSON AVE",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624012336",
            "telephone_number": "217-342-7222",
            "fax_number": "217-342-7214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANFIELD",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.