NPIMap

Organization Active NPI

Select Spine & Rehab LLC

  • Chiropractor
  • Edwardsville, IL
National Provider Identifier
1376930305
Registry record updated Jun 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.007715 Issued in IL
Legal business name
SELECT SPINE & REHAB LLC
Practice address
4 157 Ctr
Edwardsville, IL 62025-3657
Phone
(618) 235-4357
Fax
(618) 235-9865
NPI assigned
Apr 16, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2015

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

Authorized official

Name
Dr. Christopher S Worth, D.C.NPI 1811945058
Title
President
Phone
(618) 235-4357

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 038.007715 IL Primary

Addresses

Primary practice location

4 157 Ctr
Edwardsville, IL 62025-3657

Mailing address

PO Box 23617
Belleville, IL 62223-0617
Phone (618) 235-4357

National Provider Directory

National Provider Directory

Locations

4 157 Ctr
Edwardsville, IL 62025
Phone (618) 692-5555

Practitioners & affiliated clinicians

Practitioners 1

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": "1429142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433894400000",
    "number": "1376930305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23617",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622230617",
            "telephone_number": "618-235-4357",
            "fax_number": "618-235-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 157 CTR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253657",
            "telephone_number": "618-235-4357",
            "fax_number": "618-235-9865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELECT SPINE & REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-16",
        "last_updated": "2015-06-10",
        "status": "A",
        "authorized_official_last_name": "WORTH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-235-4357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.007715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2015; 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.