Individual provider Active NPI

Jonathon Serafini, D.C.

  • Chiropractor
  • Herrin, IL
National Provider Identifier
1417362500
Registry record updated Jun 26, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012640 Issued in IL
Practice address
3313 Patriot CT
Herrin, IL 62948-3782
Phone
(618) 993-9910
Fax
(618) 993-2774
NPI assigned
Jun 26, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 26, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012640 IL Primary

Addresses

Primary practice location

3313 Patriot CT
Herrin, IL 62948-3782

Mailing address

3313 Patriot CT
Herrin, IL 62948-3782
Phone (618) 993-9910

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140718001047 IL Practitioner - Chiropractic 8224254743 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Stanfield Chiropractic of Effingham LLCGroup PAC ID 4587096482, 3 clinicians
Mattoon Chiropractic LLCGroup PAC ID 1557622941, 3 clinicians

Practice addresses (Care Compare)

414 W Jefferson Ave
Effingham, IL 62401-2336
Phone (217) 342-7222

905 Remington Rd
Mattoon, IL 61938-4210
Phone (217) 234-3423

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038012640ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mattoon Chiropractic LLC Chiropractor CurrentSince Jan 1, 2026 Accepting new patients
Stanfield Chiropractic of Effingham LLC Chiropractor CurrentSince Jan 1, 2020 Accepting new patients

Locations

414 W Jefferson Ave
Effingham, IL 62401
Phone (217) 342-7222

905 Remington Rd
Mattoon, IL 61938
Phone (217) 234-3423

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": "1403740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1403740800000",
    "number": "1417362500",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3313 PATRIOT CT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483782",
            "telephone_number": "618-993-9910",
            "fax_number": "618-993-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3313 PATRIOT CT",
            "city": "HERRIN",
            "state": "IL",
            "postal_code": "629483782",
            "telephone_number": "618-993-9910",
            "fax_number": "618-993-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERAFINI",
        "first_name": "JONATHON",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-26",
        "last_updated": "2014-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Herrin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2014; 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.