Organization Active NPI

Maple City Chiropractic LTD

  • Chiropractor
  • Monmouth, IL
National Provider Identifier
1295857803
Registry record updated Jun 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008005 Issued in IL
Legal business name
MAPLE CITY CHIROPRACTIC LTD
Practice address
309 S Main St
Monmouth, IL 61462-2161
Phone
(309) 734-2447
Fax
(309) 734-0749
NPI assigned
Apr 4, 2007
Last updated
Jun 18, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2010

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

Authorized official

Name
Melissa Dawn Wegmann, D.C.
Title
Chiropractor
Phone
(309) 734-2447

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038008005 IL Primary

Addresses

Primary practice location

309 S Main St
Monmouth, IL 61462-2161

Mailing address

309 S Main St
Monmouth, IL 61462-2161
Phone (309) 734-2447

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031113000341 IL Part B Supplier - Clinic/Group Practice 2365356540 Receives reassigned benefits from 2 practitioners
Practice locations: Monmouth, IL

National Provider Directory

National Provider Directory

Locations

309 S Main St
Monmouth, IL 61462
Phone (309) 734-2447

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": "1175644800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1276819200000",
    "number": "1295857803",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 S MAIN ST",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614622161",
            "telephone_number": "309-734-2447",
            "fax_number": "309-734-0749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 S MAIN ST",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614622161",
            "telephone_number": "309-734-2447",
            "fax_number": "309-734-0749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAPLE CITY CHIROPRACTIC LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-04",
        "last_updated": "2010-06-18",
        "status": "A",
        "authorized_official_last_name": "WEGMANN",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "309-734-2447",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monmouth, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2010; 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.