Barry T Delassus, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-010459 Issued in IL

Practice address

4949 Autumn Oaks Dr
Suite a
Maryville, IL 62062-8557

Phone

(618) 288-7991

Fax

(618) 288-7901

NPI assigned

Apr 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - Davenport, 2005

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Southern Illinois Chiropractic Center

  • Chiropractor
  • Maryville, IL
  • NPI 1407991771
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372636800000",
    "number": "1427013283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4949 AUTUMN OAKS DR",
            "address_2": "SUITE A",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628557",
            "telephone_number": "618-288-7991",
            "fax_number": "618-288-7901"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4949 AUTUMN OAKS DR",
            "address_2": "SUITE A",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620628557",
            "telephone_number": "618-288-7991",
            "fax_number": "618-288-7901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DELASSUS",
        "first_name": "BARRY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2013-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038010459",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• James Joseph Dalla Riva, M.D.
• Federico Morta David
• Kimberly M. David, OTR
• Sarah Raenel 'Nel' Daymon, MS, CCC-SLP
• Arianne Elizabeth Dehr, PA-C
• Diana Demay
• Dental Professionals of Illinois, P.C.
• Dental Wellness Center of Maryville LTD
• Dependable Commute Transportation
• Dermatology Care Center, LTD.

• Chiropractor in Maryville, IL
• Providers in Maryville, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2013; 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.