Organization Active NPI

Casey Family Chiropractic LLC

Doing business as Champaign Chiropractic Clinic

  • Chiropractor
  • Jacksonville, IL
National Provider Identifier
1619346871
Registry record updated Jun 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012878 Issued in IL
Legal business name
CASEY FAMILY CHIROPRACTIC LLC
Doing business as
Champaign Chiropractic Clinic
Practice address
1515 W Walnut St Ste 6
Jacksonville, IL 62650-1157
Phone
(217) 243-5313
Fax
(217) 243-7608
NPI assigned
Sep 17, 2015
Last updated
Jun 27, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 27, 2024

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

Authorized official

Name
Dr. James Matthew Casey, DCNPI 1134598386
Title
Owner
Phone
(217) 243-5313

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
Chiropractor 111N00000X 038012878 IL Primary

Addresses

Primary practice location

1515 W Walnut St Ste 6
Jacksonville, IL 62650-1157

Mailing address

1515 W Walnut St Ste 6
Jacksonville, IL 62650-1157
Phone (217) 243-5313

Other practice location 1

1207 S Mattis Ave Ste 2
Champaign, IL 61821-4861
Phone (217) 355-5922

Other names 1

  • Champaign Chiropractic Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150929003458 IL Part B Supplier - Clinic/Group Practice 2365750064 Receives reassigned benefits from 2 practitioners
Practice locations: Jacksonville, IL

National Provider Directory

National Provider Directory

Locations

1515 W Walnut St
Ste 6
Jacksonville, IL 62650
Phone (217) 243-5313

Practitioners & affiliated clinicians

Practitioners 5

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": "1442448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719446400000",
    "number": "1619346871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W WALNUT ST STE 6",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501157",
            "telephone_number": "217-243-5313",
            "fax_number": "217-243-7608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W WALNUT ST STE 6",
            "city": "JACKSONVILLE",
            "state": "IL",
            "postal_code": "626501157",
            "telephone_number": "217-243-5313",
            "fax_number": "217-243-7608"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1207 S Mattis Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Champaign",
            "state": "IL",
            "postal_code": "618214861",
            "country_code": "US",
            "telephone_number": "217-355-5922",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CASEY FAMILY CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-17",
        "last_updated": "2024-06-27",
        "certification_date": "2024-06-27",
        "status": "A",
        "authorized_official_last_name": "CASEY",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MATTHEW",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-243-5313",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Champaign Chiropractic Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Jacksonville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2024; 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.