Individual provider Active NPI

Matthew Todd Beyers, D.C.

  • Chiropractor
  • Shelbyville, IL
National Provider Identifier
1356444954
Registry record updated Nov 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-006919 Issued in IL
Practice address
1117 W North First St
Shelbyville, IL 62565
Phone
(217) 774-5313
Fax
(217) 774-5314
NPI assigned
Sep 7, 2006
Last updated
Nov 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 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 038-006919 IL Primary

Addresses

Primary practice location

1117 W North First St
Shelbyville, IL 62565

Mailing address

1117 W North First St
Shelbyville, IL 62565
Phone (217) 774-5313

Other identifiers 1

IdentifierTypeStateIssuer
8715006OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060307000157 IL Practitioner - Chiropractic 0840206637 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 1991
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1117 W N 1St St
Shelbyville, IL 62565-1209
Phone (217) 774-5313

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-006919ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Beyers Family Chiropractic, LTD. Chiropractor CurrentSince Jan 1, 2014 Accepting new patients

Locations

1117 W North 1st St
Shelbyville, IL 62565
Phone (217) 774-5313

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1194480000000",
    "number": "1356444954",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 W NORTH FIRST ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "62565",
            "telephone_number": "217-774-5313",
            "fax_number": "217-774-5314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 W NORTH FIRST ST",
            "city": "SHELBYVILLE",
            "state": "IL",
            "postal_code": "62565",
            "telephone_number": "217-774-5313",
            "fax_number": "217-774-5314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEYERS",
        "first_name": "MATTHEW",
        "middle_name": "TODD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-07",
        "last_updated": "2007-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-006919",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8715006",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shelbyville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; 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.