NPIMap

Organization Active NPI

Wayne Davis Chiropractic Inc

  • Chiropractor
  • Moline, IL
National Provider Identifier
1447559935
Registry record updated Feb 11, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011236 Issued in IL
Legal business name
WAYNE DAVIS CHIROPRACTIC INC
Practice address
1715 5TH Ave a
Moline, IL 61265
Phone
(563) 650-4169
NPI assigned
Mar 23, 2011
Organization subpart
Yes
Parent organization
WAYNE DAVIS CHIROPRACTICAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 11, 2020

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

Authorized official

Name
Wayne Davis
Title
Owner
Phone
(563) 650-4169

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038.011236 IL Primary

Addresses

Primary practice location

1715 5TH Ave a
Moline, IL 61265

Mailing address

1715 5TH Ave a
Moline, IL 61265
Phone (563) 650-4169

Other names 1

  • Moline Chiropractic Clinic Former legal business name

National Provider Directory

National Provider Directory
Part of
Wayne Davis Chiropractic Inc

Locations

1715 5th Ave
Ste A
Moline, IL 61265
Phone (563) 650-4169

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1300838400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1581379200000",
    "number": "1447559935",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1715 5TH AVE A",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "61265",
            "telephone_number": "563-650-4169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 5TH AVE A",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "61265",
            "telephone_number": "563-650-4169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE DAVIS CHIROPRACTIC INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WAYNE DAVIS CHIROPRACTIC",
        "enumeration_date": "2011-03-23",
        "last_updated": "2020-02-11",
        "certification_date": "2020-02-11",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "563-650-4169"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011236",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moline Chiropractic Clinic",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.