NPIMap

Organization Active NPI

Selvidge Chiropractic

  • Chiropractor
  • Mattoon, IL
National Provider Identifier
1346790342
Registry record updated Oct 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008622 Issued in IL
Legal business name
SELVIDGE CHIROPRACTIC
Practice address
608 Broadway Ave
Mattoon, IL 61938-4321
Phone
(217) 235-4664
NPI assigned
Oct 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2016

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

Authorized official

Name
Dr. William Selvidge, D.C.NPI 1841347812
Title
Doctor
Phone
(217) 235-4664

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038008622 IL Primary

Addresses

Primary practice location

608 Broadway Ave
Mattoon, IL 61938-4321

Mailing address

608 Broadway Ave
Mattoon, IL 61938-4321
Phone (217) 235-4664

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476316800000",
    "number": "1346790342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384321",
            "telephone_number": "217-235-4664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 BROADWAY AVE",
            "city": "MATTOON",
            "state": "IL",
            "postal_code": "619384321",
            "telephone_number": "217-235-4664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELVIDGE CHIROPRACTIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2016-10-13",
        "status": "A",
        "authorized_official_last_name": "SELVIDGE",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "217-235-4664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattoon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2016; 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.