Organization Active NPI

Personal Best Chiropractic, LLC

  • Chiropractor
  • Monmouth, IL
National Provider Identifier
1417545658
Registry record updated Oct 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
PERSONAL BEST CHIROPRACTIC, LLC
Practice address
107 N Main St
Monmouth, IL 61462-1738
Phone
(309) 299-6968
NPI assigned
Jan 4, 2021
Last updated
Oct 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2021

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

Authorized official

Name
Payton Holmes, DCNPI 1508454737
Title
Owner
Phone
(309) 299-6968

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

107 N Main St
Monmouth, IL 61462-1738

Mailing address

510 NE 6TH Ave
Aledo, IL 61231-1155

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210830001926 IL Part B Supplier - Clinic/Group Practice 4486059466 Receives reassigned benefits from 1 practitioner
Practice locations: Monmouth, IL

National Provider Directory

National Provider Directory

Locations

107 N Main St
Monmouth, IL 61462
Phone (309) 299-6968

Practitioners & affiliated clinicians

Practitioners 1

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": "1609718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633564800000",
    "number": "1417545658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 NE 6TH AVE",
            "city": "ALEDO",
            "state": "IL",
            "postal_code": "612311155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N MAIN ST",
            "city": "MONMOUTH",
            "state": "IL",
            "postal_code": "614621738",
            "telephone_number": "309-299-6968"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PERSONAL BEST CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-04",
        "last_updated": "2021-10-07",
        "certification_date": "2021-10-07",
        "status": "A",
        "authorized_official_last_name": "HOLMES",
        "authorized_official_first_name": "PAYTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "309-299-6968",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monmouth, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2021; 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.