Individual provider Active NPI

Jeremy Book, D.C.

  • Chiropractor
  • O Fallon, IL
National Provider Identifier
1659529667
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011250 Issued in IL
Practice address
1480 N Green Mount Rd
O Fallon, IL 62269-3466
Phone
(618) 622-2222
Fax
(618) 624-8357
NPI assigned
Sep 3, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038011250 IL Primary

Addresses

Primary practice location

1480 N Green Mount Rd
O Fallon, IL 62269-3466

Mailing address

1480 N Green Mount Rd
O Fallon, IL 62269-3466
Phone (618) 622-2222

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210216000036 TN Practitioner - Chiropractic 6103988555 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1011 W Broadway Ave
Maryville, TN 37801-4638
Phone (865) 983-3333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Edc Chiropractic Inc. Chiropractor CurrentSince Sep 1, 2020 Accepting new patients
Full Potential PLLC Chiropractor CurrentSince Dec 16, 2022 Accepting new patients
Chiro-Med II, LTD Chiropractor PastSince Oct 30, 2013 Accepting new patients

Locations

210 Western Ave
South Portland, ME 04106
Phone (207) 772-4203

210 Western Ave
Ste 300
South Portland, ME 04106
Phone (207) 775-7468

1011 W Broadway Ave
Maryville, TN 37801
Phone (865) 983-3333

Organizations & group practices 3

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1659529667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 N GREEN MOUNT RD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693466",
            "telephone_number": "618-622-2222",
            "fax_number": "618-624-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 N GREEN MOUNT RD",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693466",
            "telephone_number": "618-622-2222",
            "fax_number": "618-624-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOK",
        "first_name": "JEREMY",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011250",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2008; 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.