Individual provider Active NPI

Scott T Weber, D.C.

  • Chiropractor
  • Jacksonville, IL
National Provider Identifier
1538119888
Registry record updated Jul 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038007815 Issued in IL
Practice address
1807 W Lafayette Ave
Jacksonville, IL 62650-1008
Phone
(217) 243-5438
Fax
(217) 243-3535
NPI assigned
May 10, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038007815 IL Primary

Addresses

Primary practice location

1807 W Lafayette Ave
Jacksonville, IL 62650-1008

Mailing address

1807 W Lafayette Ave
Jacksonville, IL 62650-1008
Phone (217) 243-5438

Other identifiers 1

IdentifierTypeStateIssuer
038007815MedicaidIL

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040416000373 IL Practitioner - Chiropractic 9032104393 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1807 W Lafayette Ave
Jacksonville, IL 62650-1008
Phone (217) 243-5438

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038007815ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Weber Family Chiropractic PC Chiropractor CurrentSince Jun 1, 2006 Accepting new patients

Locations

1807 W Lafayette Ave
Jacksonville, IL 62650
Phone (217) 243-5438

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1405382400000",
    "number": "1538119888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1807 W LAFAYETTE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501008",
            "telephone_number": "217-243-5438",
            "fax_number": "217-243-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1807 W LAFAYETTE AVE",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501008",
            "telephone_number": "217-243-5438",
            "fax_number": "217-243-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEBER",
        "first_name": "SCOTT",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-10",
        "last_updated": "2014-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007815",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038007815",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2014; 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.