Individual provider Active NPI

Matthew Ryan Groves, D.C.

  • Chiropractor
  • Decatur, IL
National Provider Identifier
1578865986
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011813 Issued in IL
Practice address
3419 N. Woodford St
Decatur, IL 62526
Phone
(217) 864-1253
Fax
(217) 875-5399
NPI assigned
Nov 18, 2010
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011813 IL Primary

Addresses

Primary practice location

3419 N. Woodford St
Decatur, IL 62526

Mailing address

3419 N. Woodford St
Decatur, IL 62526
Phone (217) 864-1253

Other practice location 1

4847 E US Route 36
Suite B
Decatur, IL 62521-9736
Phone (217) 864-1253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121017000167 IL Practitioner - Chiropractic 0648420265 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3419 N Woodford St
Decatur, IL 62526-2839
Phone (217) 875-7388

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scott a & Christine M Becker Chiropractor CurrentSince May 12, 2018 Accepting new patients
Groves Family Chiropractic Limited Chiropractor CurrentSince May 12, 2018 Accepting new patients

Locations

3419 N Woodford St
Decatur, IL 62526
Phone (217) 864-1253

Organizations & group practices 2

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": "1290038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1578865986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 N. WOODFORD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-864-1253",
            "fax_number": "217-875-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 N. WOODFORD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "62526",
            "telephone_number": "217-864-1253",
            "fax_number": "217-875-5399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4847 E US Route 36",
            "address_2": "Suite B",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "IL",
            "postal_code": "625219736",
            "country_code": "US",
            "telephone_number": "217-864-1253",
            "fax_number": "217-864-1391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GROVES",
        "first_name": "MATTHEW",
        "middle_name": "RYAN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-18",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011813",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.