Andrew G. Carr, D.C.
Individual provider Active NPI Chiropractor · Wood River, IL
NPI 1629282108 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1629282108
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 38010941 (IL)
- Practice address
- 234 E Ferguson Ave
Wood River, IL 62095-2002 - Phone
- (618) 254-1100
- NPI assigned
- May 10, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Logan College of Chiropractic, 2007
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
234 E Ferguson Ave
Wood River, IL 62095-2002
Phone (618) 254-1100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20070531000268 | IL | Practitioner - Chiropractic | 1052419991 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38010941 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Andrew G. Carr, D.C. P.C. | Chiropractor | Current |
Accepting new patients |
Locations
234 E Ferguson Ave
Wood River, IL 62095
Phone (618) 254-1100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38010941 | IL | Yes |
Addresses
Primary practice location
234 E Ferguson Ave
Wood River, IL 62095-2002
Mailing address
234 E Ferguson Ave
Wood River, IL 62095-2002
Phone (618) 254-1100
Other providers in Wood River, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.