Individual provider Active NPI

Nicole Georgette Paxton, D.C.

  • Chiropractor
  • Quincy, IL
National Provider Identifier
1619983103
Registry record updated Dec 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038-010422 Issued in IL
Practice address
255 S 36TH St Ste 400
Quincy, IL 62301-5806
Phone
(217) 214-2554
Fax
(217) 214-2555
NPI assigned
Aug 1, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.010422 IL
Chiropractor 111N00000X 038-010422 IL Primary

Addresses

Primary practice location

255 S 36TH St Ste 400
Quincy, IL 62301-5806

Mailing address

255 S 36TH St Ste 400
Quincy, IL 62301-5806
Phone (217) 214-2554

Other practice location 1

521 S 24th St
Quincy, IL 62301-5730
Phone (217) 222-4363

Other identifiers 1

IdentifierTypeStateIssuer
0030140272OtherILBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050722000450 IL Practitioner - Chiropractic 4587691316 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

255 S 36TH St
Suite 400
Quincy, IL 62301-5806
Phone (217) 214-2554

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038-010422ILMDChiropractor
038.010422ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Nicole G. Paxton, DC, SC Chiropractor CurrentSince Jun 21, 2010 Accepting new patients
Becky Grimm DC SC Chiropractor Past Accepting new patients
Stratton Chiropractic Center LTD Chiropractor PastSince Dec 18, 2012 Accepting new patients
Michael R Stratton Chiropractor Past Accepting new patients

Locations

521 S 24th St
Quincy, IL 62301
Phone (217) 222-4363

255 S 36th St
Ste 400
Quincy, IL 62301
Phone (217) 214-2554

Organizations & group practices 4

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1619983103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 S 36TH ST STE 400",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623015806",
            "telephone_number": "217-214-2554",
            "fax_number": "217-214-2555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 36TH ST STE 400",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623015806",
            "telephone_number": "217-214-2554",
            "fax_number": "217-214-2555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "521 S 24th St",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "IL",
            "postal_code": "623015730",
            "country_code": "US",
            "telephone_number": "217-222-4363",
            "fax_number": "217-222-8027",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAXTON",
        "first_name": "NICOLE",
        "middle_name": "GEORGETTE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-01",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.010422",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010422",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0030140272",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

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