Organization Active NPI

Tuttle Chiropractic Inc.

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1457524746
Registry record updated Dec 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.010839 Issued in IL
Legal business name
TUTTLE CHIROPRACTIC INC.
Practice address
6808 N. Knoxville Ave.
Suite B
Peoria, IL 61614
Phone
(309) 693-9200
NPI assigned
Apr 8, 2008
Last updated
Dec 29, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2017

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

Authorized official

Name
Dr. Justin Chaney Tuttle, D.C.NPI 1952573586
Title
Chiropractor
Phone
(309) 693-9200

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 038.010839 IL Primary

Addresses

Primary practice location

6808 N. Knoxville Ave.
Suite B
Peoria, IL 61614

Mailing address

6808 N. Knoxville Ave.
Suite B
Peoria, IL 61614
Phone (309) 693-9200

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080521000737 IL Part B Supplier - Clinic/Group Practice 3173692704 Receives reassigned benefits from 1 practitioner
Practice locations: Peoria, IL

National Provider Directory

National Provider Directory

Locations

6808 N Knoxville Ave
Ste B
Peoria, IL 61614
Phone (309) 690-3215

6808 N Knoxville Ave
Ste C
Peoria, IL 61614
Phone (309) 229-6451

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": "1207612800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1514505600000",
    "number": "1457524746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6808 N. KNOXVILLE AVE.",
            "address_2": "SUITE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-693-9200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6808 N. KNOXVILLE AVE.",
            "address_2": "SUITE B",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-693-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUTTLE CHIROPRACTIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-08",
        "last_updated": "2017-12-29",
        "status": "A",
        "authorized_official_last_name": "TUTTLE",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "CHANEY",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "309-693-9200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.010839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2017; 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.