Organization Active NPI

Ferrell Chiropractic, LLC

  • Chiropractor
  • O Fallon, IL
National Provider Identifier
1578740452
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010902 Issued in IL
Legal business name
FERRELL CHIROPRACTIC, LLC
Practice address
310 E Highway 50
Suite 2
O Fallon, IL 62269-2700
Phone
(618) 628-4488
Fax
(618) 628-4474
NPI assigned
Jan 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Josh Ferrell, DC
Title
Owner/Provider
Phone
(618) 628-4488

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038010902 IL Primary

Addresses

Primary practice location

310 E Highway 50
Suite 2
O Fallon, IL 62269-2700

Mailing address

310 E Highway 50
Suite 2
O Fallon, IL 62269-2700
Phone (618) 628-4488

Other identifiers 1

IdentifierTypeStateIssuer
PENDINGOtherILPENDING

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080826000431 IL Part B Supplier - Clinic/Group Practice 9931274966 Receives reassigned benefits from 2 practitioners
Practice locations: O Fallon, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1201046400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1578740452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 E HIGHWAY 50",
            "address_2": "SUITE 2",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692700",
            "telephone_number": "618-628-4488",
            "fax_number": "618-628-4474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 E HIGHWAY 50",
            "address_2": "SUITE 2",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622692700",
            "telephone_number": "618-628-4488",
            "fax_number": "618-628-4474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FERRELL CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-23",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "FERRELL",
        "authorized_official_first_name": "JOSH",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "618-628-4488",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PENDING",
            "identifier": "PENDING",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.