Individual provider Active NPI

Kathryn Mary Frances Meeker, DC

  • Chiropractor
  • Colona, IL
National Provider Identifier
1477558989
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010223 Issued in IL
Practice address
532 Green Park Ave
#6
Colona, IL 61241-9633
Phone
(309) 796-3970
Fax
(309) 796-3972
NPI assigned
Jun 21, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038-010223 IL Primary

Addresses

Primary practice location

532 Green Park Ave
#6
Colona, IL 61241-9633

Mailing address

532 Green Park Ave
#6
Colona, IL 61241-9633
Phone (309) 796-3970

Other identifiers 2

IdentifierTypeStateIssuer
038-010223OtherILSTATE LIC
3732017OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041019001403 IL Practitioner - Chiropractic 3274594676 Practice locations: Colona, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

532 Green Park Ave
Colona, IL 61241-9633
Phone (309) 796-3970

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010223ILMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1119312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1477558989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 GREEN PARK AVE",
            "address_2": "#6",
            "city": "COLONA",
            "state": "IL",
            "postal_code": "612419633",
            "telephone_number": "309-796-3970",
            "fax_number": "309-796-3972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "532 GREEN PARK AVE",
            "address_2": "#6",
            "city": "COLONA",
            "state": "IL",
            "postal_code": "612419633",
            "telephone_number": "309-796-3970",
            "fax_number": "309-796-3972"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEKER",
        "first_name": "KATHRYN",
        "middle_name": "MARY FRANCES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-06-21",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010223",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LIC",
            "identifier": "038-010223",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3732017",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Colona, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2009; 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.