Individual provider Active NPI

Matthew Morse, D.C.

  • Chiropractor
  • Bloomington, IL
National Provider Identifier
1326476557
Registry record updated Jan 21, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012490 Issued in IL
Practice address
2405 Ge Rd
Bloomington, IL 61704-8596
Phone
(309) 661-2725
Fax
(309) 661-2730
NPI assigned
Oct 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012490 IL Primary

Addresses

Primary practice location

2405 Ge Rd
Bloomington, IL 61704-8596

Mailing address

2405 Ge Rd
Bloomington, IL 61704-8596
Phone (309) 661-2725

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200411000343 IL Practitioner - Chiropractic 3476982539 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bloomington-Normal Chiropractic Wellness Center LLCGroup PAC ID 2567891625, 2 clinicians

Practice addresses (Care Compare)

2405 General Electric Rd
Suite 3
Bloomington, IL 61704-8597
Phone (309) 661-2725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012490ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Bloomington-Normal Chiropractic Wellness Center LLC Chiropractor CurrentSince Jan 19, 2020 Accepting new patients

Locations

2405 General Electric Rd
Ste 3
Bloomington, IL 61704
Phone (309) 661-2725

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": "1382659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579564800000",
    "number": "1326476557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 GE RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048596",
            "telephone_number": "309-661-2725",
            "fax_number": "309-661-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 GE RD",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048596",
            "telephone_number": "309-661-2725",
            "fax_number": "309-661-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORSE",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-25",
        "last_updated": "2020-01-21",
        "certification_date": "2020-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomington, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2020; 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.