Sportchiro, LLC

Primary specialty

Health Maintenance OrganizationTaxonomy code 302R00000X

License

038012183 Issued in IL

Legal business name

SPORTCHIRO, LLC

Practice address

1120 S State Route 157
Ste. 100
Edwardsville, IL 62025-3786

Phone

(618) 791-2983

NPI assigned

Jun 21, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Eric Douglas Dixon, DC

Title

Owner/Operator

Phone

(618) 791-2983

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340236800000",
    "number": "1396008579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 S STATE ROUTE 157",
            "address_2": "STE. 100",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253786",
            "telephone_number": "618-791-2983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 S STATE ROUTE 157",
            "address_2": "STE. 100",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253786",
            "telephone_number": "618-791-2983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTCHIRO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-06-21",
        "status": "A",
        "authorized_official_last_name": "DIXON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_middle_name": "DOUGLAS",
        "authorized_official_title_or_position": "OWNER/OPERATOR",
        "authorized_official_telephone_number": "618-791-2983",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "IL",
            "license": "038012183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Maintenance Organization in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Health Maintenance Organization in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2012; 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.