NPIMap

Organization Active NPI

Midwest Spine and Rehab Corp

  • Chiropractor
  • O'Fallon, IL
National Provider Identifier
1285830133
Registry record updated Nov 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38009537 Issued in IL
Legal business name
MIDWEST SPINE AND REHAB CORP
Practice address
705 W US Highway 50
O Fallon, IL 62269-1900
Phone
(618) 624-4242
NPI assigned
Jun 26, 2007
Last updated
Nov 23, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2007

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

Authorized official

Name
Dr. Greg Scott Komeshak, D.CNPI 1265502611
Title
Owner
Phone
(618) 624-4242

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
Chiropractor 111N00000X 38009537 IL Primary

Addresses

Primary practice location

705 W US Highway 50
O Fallon, IL 62269-1900

Mailing address

705 W US Highway 50
O Fallon, IL 62269-1900
Phone (618) 624-4242

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": "1182816000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195776000000",
    "number": "1285830133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W US HIGHWAY 50",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691900",
            "telephone_number": "618-624-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W US HIGHWAY 50",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691900",
            "telephone_number": "618-624-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST SPINE AND REHAB CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-26",
        "last_updated": "2007-11-23",
        "status": "A",
        "authorized_official_last_name": "KOMESHAK",
        "authorized_official_first_name": "GREG",
        "authorized_official_middle_name": "SCOTT",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-624-4242",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38009537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2007; 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.