Johnson Family Chiropractic of Peoria, PC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

038011802 Issued in IL

Legal business name

JOHNSON FAMILY CHIROPRACTIC OF PEORIA, PC

Practice address

3227 N Prospect Rd
Peoria, IL 61603-1544

Phone

(309) 688-8773

NPI assigned

Nov 9, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kyle Johnson, D.C.NPI 1790086577

Title

President

Phone

(309) 688-8773

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.

• Kyle Johnson, D.C.

  • Chiropractor
  • Peoria, IL
  • NPI 1790086577
  Medicare reassignment NPD Authorized official
• Thomas Naylor Stroot, D.C.

  • Chiropractor
  • Peoria, IL
  • NPI 1558377127
  NPD (past)

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

{
    "created_epoch": "1289260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1289260800000",
    "number": "1508167388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3227 N PROSPECT RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616031544",
            "telephone_number": "309-688-8773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3227 N PROSPECT RD",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616031544",
            "telephone_number": "309-688-8773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON FAMILY CHIROPRACTIC OF PEORIA, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-09",
        "last_updated": "2010-11-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KYLE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-688-8773",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "IL",
            "license": "038011802",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John B. Dale, DMD, Ms, P.C.
• John C. Proctor Endowment
• John Day & Associates, LTD
• John P Gysin OD
• Jisha M John, PHARM D.
• Amanda J Johnson, SPEECH THERAPIST
• Amirah Johnson
• Amy C Johnson, PT
• Aretha Diane Johnson, FNP
• Bradley A Johnson, MD

• Clinic/Center in Peoria, IL
• Providers in Peoria, IL by specialty
• Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2010; 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.