Organization Active NPI

Chiropractic Wellness Center of Mt Vernon, LLC.

  • Chiropractor
  • Mount Vernon, IL
National Provider Identifier
1487145454
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013015 Issued in IL
Legal business name
CHIROPRACTIC WELLNESS CENTER OF MT VERNON, LLC.
Practice address
1708 Jefferson Ave Ste 240
Mount Vernon, IL 62864-4309
Phone
(618) 731-1965
Fax
(618) 316-7206
NPI assigned
May 24, 2018
Last updated
Oct 21, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Authorized official

Name
Dr. Nichole Lamaster, DCNPI 1871909853
Title
Chiropractor/ Owner
Phone
(618) 731-2686

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
Chiropractor 111N00000X 038013015 IL Primary

Addresses

Primary practice location

1708 Jefferson Ave Ste 240
Mount Vernon, IL 62864-4309

Mailing address

1708 Jefferson Ave Ste 240
Mount Vernon, IL 62864-4309
Phone (618) 731-1965

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180713001720 IL Part B Supplier - Clinic/Group Practice 2365798840 Receives reassigned benefits from 1 practitioner
Practice locations: Mount Vernon, IL

National Provider Directory

National Provider Directory

Locations

1009 S 42nd St
Ste 5
Mount Vernon, IL 62864
Phone (618) 731-1965

1708 Jefferson Ave
Ste 240
Mount Vernon, IL 62864
Phone (618) 731-1965

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": "1527120000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761004800000",
    "number": "1487145454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1708 JEFFERSON AVE STE 240",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628644309",
            "telephone_number": "618-731-1965",
            "fax_number": "618-316-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1708 JEFFERSON AVE STE 240",
            "city": "MOUNT VERNON",
            "state": "IL",
            "postal_code": "628644309",
            "telephone_number": "618-731-1965",
            "fax_number": "618-316-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC WELLNESS CENTER OF MT VERNON, LLC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-24",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A",
        "authorized_official_last_name": "LAMASTER",
        "authorized_official_first_name": "NICHOLE",
        "authorized_official_title_or_position": "CHIROPRACTOR/ OWNER",
        "authorized_official_telephone_number": "618-731-2686",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2025; 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.