Complete Spine and Performance LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

COMPLETE SPINE AND PERFORMANCE LLC

Practice address

521 Belt Line Rd
Collinsville, IL 62234-4411

Phone

(618) 855-9130

Fax

(618) 855-9111

NPI assigned

Aug 30, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Blake Reed, D.C.NPI 1770156937

Title

Owner/Chiropractor

Phone

(618) 855-9130

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Blake Reed, D.C.

  • Rehabilitation Chiropractor
  • Granite City, IL
  • NPI 1770156937
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693353600000",
    "number": "1417732009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 SANDRIDGE DR",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622343792",
            "telephone_number": "618-977-7317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 BELT LINE RD",
            "city": "COLLINSVILLE",
            "state": "IL",
            "postal_code": "622344411",
            "telephone_number": "618-855-9130",
            "fax_number": "618-855-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE SPINE AND PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A",
        "authorized_official_last_name": "REED",
        "authorized_official_first_name": "BLAKE",
        "authorized_official_title_or_position": "OWNER/CHIROPRACTOR",
        "authorized_official_telephone_number": "618-855-9130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Collinsville Hco, LLC
• Collinsville Orthodontics PLLC
• Collinsville Pediatric Dentistry PLLC
• Collinsville Physical Therapy & Wellness, LLC
• Collinsville Unit School District #10
• Courtney Gene Cooper, PT, DPT
• Minnie Ellen Cornett, REGISTERED NURSE
• Joseph Michael Corvallis, M.D.
• Tonia Lynette Cotton
• Courtney Pharmacies, PC

• Clinic/Center in Collinsville, IL
• Providers in Collinsville, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.