Individual provider Active NPI

Shamika Cordis, D.C.

  • Chiropractor
  • Chicago, IL
National Provider Identifier
1457642936
Registry record updated Feb 1, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012064 Issued in IL
Practice address
3927 W Belmont Ave
Ste 101
Chicago, IL 60618-5170
Phone
(773) 557-7780
Fax
(773) 557-7781
NPI assigned
May 2, 2011
Last updated
Feb 1, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012064 IL Primary

Addresses

Primary practice location

3927 W Belmont Ave
Ste 101
Chicago, IL 60618-5170

Mailing address

PO Box 5977
Dept 20-3028
Carol Stream, IL 60197-5977
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160316000988 WA Practitioner - Chiropractic 1456598861 Reassigns benefits to 2 organizations
Practice locations: Olympia, WA; Lakewood, WA

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1018 7TH Ave SE
Olympia, WA 98501-1512
Phone (360) 728-0315

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
CB Chiropractic PLLC CurrentSince Sep 1, 2016 Accepting new patients
Phoenix Rising Wellness Center Chiropractor CurrentSince Mar 24, 2017 Accepting new patients
Natural Wellness Center, PS Chiropractor CurrentSince Feb 4, 2016 Accepting new patients
Chiro One Wellness Center Metro of Avondale LLC Chiropractor Past Accepting new patients
Provasoli Chiropractic Inc. Past Accepting new patients
Thurston Internal Medicine PLLC PastSince Oct 17, 2021 Accepting new patients

Locations

1409 S 348th St
Ste D103
Federal Way, WA 98003
Phone (253) 839-8608

2026 54th Ave E
Fife, WA 98424
Phone (253) 777-3889

11008 Gravelly Lake Dr SW
Lakewood, WA 98499
Phone (253) 220-0711

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1304294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359676800000",
    "number": "1457642936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5977",
            "address_2": "DEPT 20-3028",
            "city": "CAROL STREAM",
            "state": "IL",
            "postal_code": "601975977",
            "telephone_number": "630-468-1824",
            "fax_number": "630-701-1007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 W BELMONT AVE",
            "address_2": "STE 101",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606185170",
            "telephone_number": "773-557-7780",
            "fax_number": "773-557-7781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORDIS",
        "first_name": "SHAMIKA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-05-02",
        "last_updated": "2013-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012064",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

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