NPIMap

Organization Active NPI

Illume Chiropractic, LLC

  • Chiropractor
  • Coshocton, OH
National Provider Identifier
1497147177
Registry record updated Feb 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
DC.4491 Issued in OH
Legal business name
ILLUME CHIROPRACTIC, LLC
Practice address
305 Downtowner PLZ
Coshocton, OH 43812-1928
Phone
(740) 562-5600
NPI assigned
Mar 4, 2015
Last updated
Feb 4, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2016

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

Authorized official

Name
Tanner Dickerson, DCNPI 1528458734
Title
Chiropractor
Phone
(740) 562-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X DC.4491 OH Primary

Addresses

Primary practice location

305 Downtowner PLZ
Coshocton, OH 43812-1928

Mailing address

1867 S 14TH St
Coshocton, OH 43812-2912
Phone (740) 562-5600

National Provider Directory

National Provider Directory

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": "1425427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454544000000",
    "number": "1497147177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1867 S 14TH ST",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438122912",
            "telephone_number": "740-562-5600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 DOWNTOWNER PLZ",
            "city": "COSHOCTON",
            "state": "OH",
            "postal_code": "438121928",
            "telephone_number": "740-562-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ILLUME CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-04",
        "last_updated": "2016-02-04",
        "status": "A",
        "authorized_official_last_name": "DICKERSON",
        "authorized_official_first_name": "TANNER",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "740-562-5600",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "DC.4491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coshocton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.