Individual provider Active NPI

John Girado, DC

  • Chiropractor
  • Carbondale, IL
National Provider Identifier
1285786079
Registry record updated Jul 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038006734 Issued in IL
Practice address
205 E Main St
Carbondale, IL 62901-3008
Phone
(618) 457-0459
Fax
(618) 549-9203
NPI assigned
Jan 18, 2007
Last updated
Jul 23, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038006734 IL Primary

Addresses

Primary practice location

205 E Main St
Carbondale, IL 62901-3008

Mailing address

205 E Main St
Carbondale, IL 62901-3008
Phone (618) 457-0459

Other identifiers 2

IdentifierTypeStateIssuer
038006734OtherILIL LICENSE
371267591OtherILTAX ID

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
038006734ILMDChiropractor
20337CAMDAdult Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Girardo Chiropractic Center Chiropractor PastSince Nov 15, 1990 Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279843200000",
    "number": "1285786079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "205 E MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013008",
            "telephone_number": "618-457-0459",
            "fax_number": "618-549-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 E MAIN ST",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "629013008",
            "telephone_number": "618-457-0459",
            "fax_number": "618-549-9203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIRADO",
        "first_name": "JOHN",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-18",
        "last_updated": "2010-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038006734",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IL LICENSE",
            "identifier": "038006734",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX ID",
            "identifier": "371267591",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2010; 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.