Organization Active NPI

Andersen Chiropractic Health, S.C.

  • Rehabilitation Chiropractor
  • Champaign, IL
National Provider Identifier
1548645567
Registry record updated Jul 22, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
ANDERSEN CHIROPRACTIC HEALTH, S.C.
Practice address
606 N Country Fair Dr
Suite B
Champaign, IL 61821-2496
Phone
(217) 351-1980
Fax
(217) 351-4070
NPI assigned
Jul 21, 2015
Last updated
Jul 22, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2015

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

Authorized official

Name
Dr. Norman D Andersen Jr., D.C.NPI 1306891411
Title
Owner
Phone
(217) 351-1980

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111NR0400X IL Primary

Addresses

Primary practice location

606 N Country Fair Dr
Suite B
Champaign, IL 61821-2496

Mailing address

606 N Country Fair Dr
Suite B
Champaign, IL 61821-2496
Phone (217) 351-1980

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150723006586 IL Part B Supplier - Clinic/Group Practice 6204149008 Receives reassigned benefits from 1 practitioner
Practice locations: Champaign, IL

National Provider Directory

National Provider Directory

Locations

606 N Country Fair Dr
Ste B
Champaign, IL 61821
Phone (217) 351-1980

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": "1437436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1437523200000",
    "number": "1548645567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "606 N COUNTRY FAIR DR",
            "address_2": "SUITE B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212496",
            "telephone_number": "217-351-1980",
            "fax_number": "217-351-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 N COUNTRY FAIR DR",
            "address_2": "SUITE B",
            "city": "CHAMPAIGN",
            "state": "IL",
            "postal_code": "618212496",
            "telephone_number": "217-351-1980",
            "fax_number": "217-351-4070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANDERSEN CHIROPRACTIC HEALTH, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-21",
        "last_updated": "2015-07-22",
        "status": "A",
        "authorized_official_last_name": "ANDERSEN",
        "authorized_official_first_name": "NORMAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-351-1980",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Champaign, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2015; 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.