Individual provider Active NPI

Gerald Henry Bemis Jr., D.C.

  • Chiropractor
  • Alton, IL
National Provider Identifier
1295891463
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
240 W Elm St
Alton, IL 62002-5126
Phone
(618) 466-5322
Fax
(618) 466-9523
NPI assigned
Dec 29, 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

240 W Elm St
Alton, IL 62002-5126

Mailing address

4900 Airport Rd
Godfrey, IL 62035-3205
Phone (618) 531-7056

Other identifiers 4

IdentifierTypeStateIssuer
26040510OtherILBLUE CROSS BLUE SHEILD IL
4388568OtherILAETNA
4405903OtherILUNITED HEALTHCARE
102803OtherILHEALTHLINK

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopedic & Sports Medicine Clinic, P.C. PastSince Nov 10, 2011 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167350400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295891463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 AIRPORT RD",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620353205",
            "telephone_number": "618-531-7056"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 W ELM ST",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620025126",
            "telephone_number": "618-466-5322",
            "fax_number": "618-466-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEMIS",
        "first_name": "GERALD",
        "middle_name": "HENRY",
        "name_suffix": "Jr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHEILD IL",
            "identifier": "26040510",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4388568",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "4405903",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "102803",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Alton, 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.