Individual provider Active NPI

John Alan Nolen, D.C.

  • Chiropractor
  • West Frankfort, IL
National Provider Identifier
1376559062
Registry record updated Feb 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
38003613 Issued in IL
Practice address
107 S Van Buren St
West Frankfort, IL 62896-2907
Phone
(618) 937-4164
Fax
(618) 932-3203
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 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 38003613 IL Primary

Addresses

Primary practice location

107 S Van Buren St
West Frankfort, IL 62896-2907

Mailing address

1000 Factory Outlet Blvd
Ste 111
West Frankfort, IL 62896-4179
Phone (618) 937-4164

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101203000665 IL Practitioner - Chiropractic 0042407025 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 1976
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1000 Factory Outlet Blvd
Suite 111
West Frankfort, IL 62896-4178

1000 Factory Outlet Blvd
Suite 111
West Frankfort, IL 62896-4179
Phone (618) 937-4164

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
38003613ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nolen Clinic LTD. CurrentSince Jul 1, 1982 Accepting new patients

Locations

1000 Factory Outlet Blvd
Ste 111
West Frankfort, IL 62896
Phone (618) 932-4164

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581120000000",
    "number": "1376559062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 FACTORY OUTLET BLVD",
            "address_2": "STE 111",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628964179",
            "telephone_number": "618-937-4164",
            "fax_number": "618-932-3203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 S VAN BUREN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628962907",
            "telephone_number": "618-937-4164",
            "fax_number": "618-932-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLEN",
        "first_name": "JOHN",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2020-02-08",
        "certification_date": "2020-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "38003613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Frankfort, IL

Sources for this page

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