Individual provider Active NPI

Chad Falconer, P.T.

  • Physical Therapist
  • Hannibal, MO
National Provider Identifier
1578577201
Registry record updated Feb 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
108148 Issued in MO
Practice address
3652 Stardust Dr
Hannibal, MO 63401-6212
Phone
(573) 221-8800
Fax
(573) 221-1808
NPI assigned
Jul 28, 2006
Last updated
Feb 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 108148 MO Primary

Addresses

Primary practice location

3652 Stardust Dr
Hannibal, MO 63401-6212

Mailing address

3652 Stardust Dr
Hannibal, MO 63401-6212
Phone (573) 221-8800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060404000038 MO Practitioner - Physical Therapist in Private Practice 6002882214 Reassigns benefits to 1 organization
I20130228000220 IL Practitioner - Physical Therapist in Private Practice 6002882214 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1089 Jason PL
Chatham, IL 62629-2018
Phone (217) 483-5858

1804 Elm St
Canton, MO 63435-1694
Phone (573) 288-3311

4800 Maine St
Suite 48 100
Quincy, IL 62305-5875
Phone (217) 222-6800

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advance Physical Therapy & Sports Medicine of Adams County LLC CurrentSince Nov 1, 2012 Accepting new patients
Advance Hannibal Regional Hospital LLC Physical Therapist CurrentSince Apr 5, 2018 Accepting new patients
Advance Physical Therapy & Sports Medicine of Adams County LLC Physical Therapist CurrentSince Nov 1, 2012 Accepting new patients
Advance Hannibal Regional Hospital, LLC Physical Therapist CurrentSince Apr 5, 2018 Accepting new patients
Advance Physical Therapy & Sports Medicine of Chatham LLC Physical Therapist CurrentSince Feb 1, 2019 Accepting new patients
Advance Physical Therapy & Sports Medicine of Chatham LLC CurrentSince Feb 1, 2019 Accepting new patients
Advance Physical Therapy & Sports Medicine of Lewis County LLC Physical Therapist PastSince Aug 8, 2012 Accepting new patients
Advance PT Therapy of Hannibal LLC Physical Therapist PastSince Aug 8, 2012 Accepting new patients
Advance Physical Therapy & Sports Medicine LLC Physical Therapist PastSince Sep 1, 2002 Accepting new patients

Locations

1089 Jason Pl
Chatham, IL 62629
Phone (217) 483-5858

100 W Main St
Mt Sterling, IL 62353
Phone (217) 483-5858

3032 Broadway St
Quincy, IL 62301
Phone (217) 617-3412

4800 Maine St
Ste 48100
Quincy, IL 62305
Phone (218) 316-2937

927 Broadway St
Ste 100
Quincy, IL 62301
Phone (217) 222-9300

1100 E Outer Rd S
Ste 1
Canton, MO 63435
Phone (573) 288-3311

1804 Elm St
Canton, MO 63435
Phone (573) 288-3311

160 Progress Rd
#111
Hannibal, MO 63401

188 Medical Dr
#A
Hannibal, MO 63401
Phone (573) 406-0576

188A Medical Dr
Hannibal, MO 63401
Phone (573) 406-0576

55 Troy Sq
Troy, MO 63379
Phone (636) 528-7333

Organizations & group practices 10

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": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204156800000",
    "number": "1578577201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3652 STARDUST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016212",
            "telephone_number": "573-221-8800",
            "fax_number": "573-221-1808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3652 STARDUST DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634016212",
            "telephone_number": "573-221-8800",
            "fax_number": "573-221-1808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALCONER",
        "first_name": "CHAD",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2008-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "108148",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2008; 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.