Active NPI
Clarence Holtschlag
- Chiropractor
- Quincy, IL
National Provider Identifier
1386107217
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.013356
- Practice address
- 2000 Jefferson St
Quincy, IL 62301-5655 - Phone
- (217) 228-2040
- NPI assigned
- Apr 8, 2019
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.013356 | IL | Primary |
Addresses
Primary practice location
2000 Jefferson St
Quincy, IL 62301-5655
Mailing address
2000 Jefferson St
Quincy, IL 62301-5655
Phone (217) 228-2040
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190424002158 | IL | Practitioner - Chiropractic | 8224370119 | Practice locations: Quincy, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2000 Jefferson St
Quincy, IL 62301-5655
Phone (217) 228-2040
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.013356 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554768000000",
"number": "1386107217",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2000 JEFFERSON ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623015655",
"telephone_number": "217-228-2040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 JEFFERSON ST",
"city": "QUINCY",
"state": "IL",
"postal_code": "623015655",
"telephone_number": "217-228-2040"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOLTSCHLAG",
"first_name": "CLARENCE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-08",
"last_updated": "2019-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.013356",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Quincy, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2019; 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.