NPIMap

Organization Active NPI

Clanahan Wellness Center Inc

  • Chiropractor
  • Pekin, IL
National Provider Identifier
1396851374
Registry record updated Oct 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038008668 Issued in IL
Legal business name
CLANAHAN WELLNESS CENTER INC
Practice address
105 N Parkway Dr
Pekin, IL 61554-3932
Phone
(309) 353-3300
Fax
(309) 353-7961
NPI assigned
Aug 22, 2006
Last updated
Oct 19, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2016

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

Authorized official

Name
Todd H Clanahan, DCNPI 1992713101
Title
President
Phone
(309) 353-3300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038008668 IL Primary

Addresses

Primary practice location

105 N Parkway Dr
Pekin, IL 61554-3932

Mailing address

105 N Parkway Dr
Pekin, IL 61554-3932
Phone (309) 353-3300

Other identifiers 2

IdentifierTypeStateIssuer
09022697OtherILBLUE CROSS BLUE SHIELD
3500559154OtherILRAILROAD MEDICARE

National Provider Directory

National Provider Directory

Locations

105 N Parkway Dr
Pekin, IL 61554
Phone (309) 353-3300

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1476835200000",
    "number": "1396851374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 N PARKWAY DR",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543932",
            "telephone_number": "309-353-3300",
            "fax_number": "309-353-7961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 N PARKWAY DR",
            "city": "PEKIN",
            "state": "IL",
            "postal_code": "615543932",
            "telephone_number": "309-353-3300",
            "fax_number": "309-353-7961"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLANAHAN WELLNESS CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2016-10-19",
        "status": "A",
        "authorized_official_last_name": "CLANAHAN",
        "authorized_official_first_name": "TODD",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-353-3300",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038008668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "09022697",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "3500559154",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pekin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; 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.