Grady Matthew Birdsell, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Practice address

1201 5TH Ave
Moline, IL 61265-1331

Phone

(309) 764-8821

Fax

(309) 757-4773

NPI assigned

Sep 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 1983

Medicare assignment

May accept Medicare assignment

Group practices

Birdsell Chiropractic and Acupuncture Clinic, CharteredGroup PAC ID 3476641606, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Birdsell Chiropractic & Acupuncture Clinic, Chartered

  • Chiropractor
  • Moline, IL
  • NPI 1831292457
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196640000000",
    "number": "1366545576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651331",
            "telephone_number": "309-764-8821",
            "fax_number": "309-757-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651331",
            "telephone_number": "309-764-8821",
            "fax_number": "309-757-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRDSELL",
        "first_name": "GRADY",
        "middle_name": "MATTHEW",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-06",
        "last_updated": "2007-12-03",
        "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 BS",
            "identifier": "8182020",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy L Bier, APRN-FNP-BC
• James Kenneth Billman Jr., MD
• Katherine Bird, DPT
• Birdsell Chiropractic & Acupuncture Clinic, Chartered
• David R Birdsell, DC
• Melissa Kae Birdsell, D.C.
• Catherine A Bishop, D.D.S.
• James E. Bishop, D.D.S.
• Pscal Muhitira Bizimana
• Andrea M Black, PA-C

• Chiropractor in Moline, IL
• Providers in Moline, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.