Wyatt Chiropractic Clinic, LTD

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038004748 Issued in IL

Legal business name

WYATT CHIROPRACTIC CLINIC, LTD

Practice address

731 S West St
Olney, IL 62450

Phone

(618) 392-5511

NPI assigned

May 15, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Ronald Jay Greenberg, D.C.NPI 1407921448

Title

Chief Executive Officer

Phone

(618) 392-5511

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 2

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

• Ronald Jay Greenberg, DC

  • Chiropractor
  • Olney, IL
  • NPI 1407921448
  Medicare reassignment NPD Authorized official
• Jeffrey Alan Kocher, DC

  • Chiropractor
  • Olney, IL
  • NPI 1881769826
  NPD (past)

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

{
    "created_epoch": "1179187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318464000000",
    "number": "1467668574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 S WEST ST",
            "address_2": "PO BOX 96",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "62450",
            "telephone_number": "618-392-5511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 S WEST ST",
            "city": "OLNEY",
            "state": "IL",
            "postal_code": "62450",
            "telephone_number": "618-392-5511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WYATT CHIROPRACTIC CLINIC, LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-15",
        "last_updated": "2011-10-13",
        "status": "A",
        "authorized_official_last_name": "GREENBERG",
        "authorized_official_first_name": "RONALD",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "618-392-5511",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038004748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Katrina Williams, OTR/L
• Rickie Wood, BS
• Lucinda Woodworth, RN
• Yanci Jo Shroyer & Associates LLC
• Catherine S Yockey, RN,MSN
• Rachel Leeann Yockey
• Jana Young
• Breanna Zuber, MPH

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.