Core Physical Medicine LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038007715 Issued in IL

Legal business name

CORE PHYSICAL MEDICINE LLC

Practice address

4 157 Ctr
Edwardsville, IL 62025-3657

Phone

(618) 692-5555

Fax

(618) 692-5034

NPI assigned

Jun 11, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Christopher S Worth, D.C.

Title

Sole Member

Phone

(618) 692-5555

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1433980800000",
    "number": "1659752095",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23617",
            "city": "BELLEVILLE",
            "state": "IL",
            "postal_code": "622230617",
            "telephone_number": "618-235-4357",
            "fax_number": "618-692-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 157 CTR",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253657",
            "telephone_number": "618-692-5555",
            "fax_number": "618-692-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE PHYSICAL MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-06-11",
        "last_updated": "2015-06-11",
        "status": "A",
        "authorized_official_last_name": "WORTH",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "618-692-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038007715",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Cook
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• Chiropractor in Edwardsville, IL
• Providers in Edwardsville, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.