Individual provider Active NPI

Andrea Kay Forget-Schnowske, DC

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1407123136
Registry record updated Mar 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012085 Issued in IL
Practice address
4812 N Sheridan Rd
Peoria, IL 61614-5928
Phone
(309) 689-6200
Fax
(309) 689-6219
NPI assigned
Nov 23, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012085 IL Primary

Addresses

Primary practice location

4812 N Sheridan Rd
Peoria, IL 61614-5928

Mailing address

4812 N Sheridan Rd
Peoria, IL 61614-5928
Phone (309) 689-6200

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000526 IL Practitioner - Chiropractic 2567639909 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

4700 N University St
SPC 65
Peoria, IL 61614-5849
Phone (309) 689-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012085ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Alp Wellness Inc Chiropractor CurrentSince Mar 16, 2016 Accepting new patients
Physicians Sports & Injury Center, Inc Past Accepting new patients

Locations

4700 N University St
Spc 65
Peoria, IL 61614
Phone (309) 689-6200

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332288000000",
    "number": "1407123136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4812 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145928",
            "telephone_number": "309-689-6200",
            "fax_number": "309-689-6219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4812 N SHERIDAN RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616145928",
            "telephone_number": "309-689-6200",
            "fax_number": "309-689-6219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORGET-SCHNOWSKE",
        "first_name": "ANDREA",
        "middle_name": "KAY",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-23",
        "last_updated": "2012-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012085",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

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

Verify at the official NPI Registry.