TCWC Glen Carbon, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038012948 Issued in IL

Legal business name

TCWC GLEN CARBON, LLC

Doing business as

The Chiropractic Wellness Connection Glen Carbon

Practice address

11 Ginger Creek VLG
Glen Carbon, IL 62034-3517

Phone

(618) 307-9540

NPI assigned

Apr 8, 2016

Last updated

Sep 12, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Christina T Claywell, DCNPI 1689066573

Title

Owner

Phone

(618) 792-2762

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• The Chiropractic Wellness Connection Glen Carbon Doing business as

Locations

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.

• Christina Tassinari Claywell, D.C.

  • Chiropractor
  • Glen Carbon, IL
  • NPI 1689066573
  Authorized official Same address or phone

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

{
    "created_epoch": "1460073600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1473638400000",
    "number": "1528422235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1901 CHEYENNE DR",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "620351532",
            "telephone_number": "618-792-2762",
            "fax_number": "636-978-7570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 GINGER CREEK VLG",
            "city": "GLEN CARBON",
            "state": "IL",
            "postal_code": "620343517",
            "telephone_number": "618-307-9540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TCWC GLEN CARBON, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-08",
        "last_updated": "2016-09-12",
        "status": "A",
        "authorized_official_last_name": "CLAYWELL",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-792-2762",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012948",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL NPI",
            "identifier": "1689066573",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Chiropractic Wellness Connection Glen Carbon",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Glen Carbon, IL
• Providers in Glen Carbon, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.