Individual provider Active NPI

Eric Edward Carson, D.C.

  • Chiropractor
  • Oswego, IL
National Provider Identifier
1518991462
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
4541 State Route 71
Oswego, IL 60543-7416
Phone
(630) 551-1003
Fax
(630) 551-4914
NPI assigned
Jul 10, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

4541 State Route 71
Oswego, IL 60543-7416

Mailing address

4541 State Route 71
Oswego, IL 60543-7416
Phone (630) 551-1003

Other identifiers 2

IdentifierTypeStateIssuer
047-32019OtherILBC/BS PROVIDER #
214-1847OtherILFIRSTHEALTH PROVIDER#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040405001219 IL Practitioner - Chiropractic 8820081052 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Sherman College of Straight Chiropractic, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4541 State Route 71
Oswego, IL 60543-7416
Phone (630) 551-1003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-009980ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Carson Chiropractic, L.L.C. Chiropractor CurrentSince Mar 1, 2004 Accepting new patients

Locations

4541 State Route 71
Oswego, IL 60543
Phone (630) 551-1003

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1518991462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4541 STATE ROUTE 71",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437416",
            "telephone_number": "630-551-1003",
            "fax_number": "630-551-4914"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4541 STATE ROUTE 71",
            "city": "OSWEGO",
            "state": "IL",
            "postal_code": "605437416",
            "telephone_number": "630-551-1003",
            "fax_number": "630-551-4914"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARSON",
        "first_name": "ERIC",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS PROVIDER #",
            "identifier": "047-32019",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTHEALTH PROVIDER#",
            "identifier": "214-1847",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Oswego, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.