Performance Spine and Sports Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

038011628 Issued in IL

Legal business name

PERFORMANCE SPINE AND SPORTS CENTER, LLC

Practice address

332 S 36TH St
Suite 3
Quincy, IL 62301-5808

Phone

(731) 796-6910

NPI assigned

Mar 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Wesley David Creech, D.C.NPI 1548424567

Title

Chiropractor

Phone

(731) 796-6910

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wesley David Creech, D.C.

  • Chiropractor
  • Quincy, IL
  • NPI 1548424567
  Medicare reassignment Authorized official
• Erik Nothold, D.C.

  • Chiropractor
  • Quincy, IL
  • NPI 1588112403
  NPD

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

{
    "created_epoch": "1268092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268092800000",
    "number": "1386967099",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 JONES RD",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382619023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "332 S 36TH ST",
            "address_2": "SUITE 3",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623015808",
            "telephone_number": "731-796-6910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERFORMANCE SPINE AND SPORTS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-09",
        "last_updated": "2010-03-09",
        "status": "A",
        "authorized_official_last_name": "CREECH",
        "authorized_official_first_name": "WESLEY",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "731-796-6910",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "038011628",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Olivia Louise Patterson, APRN-PMHNP
• Paul E. Obrock, DMD, PC (Cornerstone Dental Health)
• Cindy A Paul, RN
• Nicole Georgette Paxton, D.C.
• Melissa Kay Penn, LCSW
• Rebecca S Perrine, LMT
• Crystal L. Perry, M.D.
• Personal Care Services Inc. (Summer House)
• Emily J Peter, LPC
• Anna Jil Peters, LPC

• Clinic/Center in Quincy, IL
• Providers in Quincy, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.