Active NPI
Breane Michelle Schafer, D.C.
- Chiropractor
- Godfrey, IL
National Provider Identifier
1437469111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038.011768
- Practice address
- 1316 Dadrian Professional Park
Godfrey, IL 62035-1685 - Phone
- (618) 467-0300
- Fax
- (618) 467-4065
- NPI assigned
- Oct 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 038.011768 | IL | Primary |
Addresses
Primary practice location
1316 Dadrian Professional Park
Godfrey, IL 62035-1685
Mailing address
1316 D'Adrian Professional Park
Godfrey, IL 62035-9719
Phone (618) 467-0300
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110303000562 | IL | Practitioner - Chiropractic | 6305028960 | Practice locations: Quincy, IL |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2010
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
307 N 36TH St
Quincy, IL 62301-3760
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038.011768 | IL | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1287100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1297036800000",
"number": "1437469111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1316 D'ADRIAN PROFESSIONAL PARK",
"city": "GODFREY",
"state": "IL",
"postal_code": "620359719",
"telephone_number": "618-467-0300",
"fax_number": "618-467-4065"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1316 DADRIAN PROFESSIONAL PARK",
"city": "GODFREY",
"state": "IL",
"postal_code": "620351685",
"telephone_number": "618-467-0300",
"fax_number": "618-467-4065"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHAFER",
"first_name": "BREANE",
"middle_name": "MICHELLE",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-10-15",
"last_updated": "2011-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038.011768",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Godfrey, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2011; 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.