Individual provider Active NPI

James Womick, DC

  • Sports Physician Chiropractor
  • Norfolk, VA
National Provider Identifier
1609071281
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
0104557816 Issued in VA
Practice address
111 W Virginia Beach Blvd
Norfolk, VA 23510-2005
Phone
(757) 623-7776
NPI assigned
Jun 15, 2007
Last updated
Feb 21, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 038-007498 IL
Sports Physician Chiropractor 111NS0005X 0104557816 VA Primary

Addresses

Primary practice location

111 W Virginia Beach Blvd
Norfolk, VA 23510-2005

Mailing address

10519 Highway 149
PO Box 1649
Murphysboro, IL 62966-3310

Other practice location 1

10519 Highway 149
Murphysboro, IL 62966-3310
Phone (618) 687-4000

Other identifiers 3

IdentifierTypeStateIssuer
350046774OtherILRR MEDICARE
3921560OtherILBLUE CROSS BLUE SHIELD
038007498MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL, VA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190806004259 IL Practitioner - Chiropractic 0042547556 Reassigns benefits to 1 organization
I20240524002623 VA Practitioner - Chiropractic 0042547556 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-007498ILMDSports Physician Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Premise Health of Illinois Medical PC CurrentSince Jul 7, 2025 Accepting new patients
Balance Wellspace Integrative Medicine, Inc. CurrentSince Apr 10, 2024 Accepting new patients
Premise Health of Illinois Medical PC CurrentSince Jul 7, 2025 Accepting new patients
Premise Health of Illinois Medical PC Current Accepting new patients
Morningstar Chiropractic & Rehabilitation Center LTD CurrentSince May 27, 2021 Accepting new patients

Locations

16906 Collection Ctr Dr
Chicago, IL 60693

6150 Joliet Rd
Countryside, IL 60525
Phone (708) 485-2273

3733 S State Route 159
Glen Carbon, IL 62034
Phone (618) 288-8090

2266 Madison Ave
Granite City, IL 62040
Phone (618) 288-8090

5500 Maryland Way
Ste 120
Brentwood, TN 37027

2725 Market St
Christiansburg, VA 24073
Phone (540) 343-0055

2522 Colonial Ave SW
Roanoke, VA 24015
Phone (540) 343-0055

Organizations & group practices 5

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1609071281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10519 HIGHWAY 149",
            "address_2": "PO BOX 1649",
            "city": "MURPHYSBORO",
            "state": "IL",
            "postal_code": "629663310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 W VIRGINIA BEACH BLVD",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102005",
            "telephone_number": "757-623-7776"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "10519 Highway 149",
            "address_purpose": "LOCATION",
            "city": "Murphysboro",
            "state": "IL",
            "postal_code": "629663310",
            "country_code": "US",
            "telephone_number": "618-687-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOMICK",
        "first_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "IL",
            "license": "038-007498",
            "primary": false
        },
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "VA",
            "license": "0104557816",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "350046774",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "3921560",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038007498",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Norfolk, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.