Wood River Chiropractic, LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

WOOD RIVER CHIROPRACTIC, LLC

Practice address

203 S 6TH St
Wood River, IL 62095-2345

Phone

(618) 254-9355

NPI assigned

Feb 10, 2017

Last updated

Feb 10, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kelly StanfieldNPI 1285670034

Title

Owner

Phone

(217) 821-5663

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 4

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.

• Kelly L Stanfield, D.C.

  • Chiropractor
  • Effingham, IL
  • NPI 1285670034
  Medicare reassignment NPD Authorized official
• Aaron Clay Roby

  • Chiropractor
  • Swansea, IL
  • NPI 1811205602
  Medicare reassignment NPD
• Christina Faccin, D.C.

  • Chiropractor
  • Alton, IL
  • NPI 1609870294
  NPD (past)
• Jacob Funk, D.C.

  • Chiropractor
  • East Alton, IL
  • NPI 1700194750
  NPD (past)

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

{
    "created_epoch": "1486684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1486684800000",
    "number": "1659819530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 S 6TH ST",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620952345",
            "telephone_number": "618-254-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 S 6TH ST",
            "city": "WOOD RIVER",
            "state": "IL",
            "postal_code": "620952345",
            "telephone_number": "618-254-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WOOD RIVER CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-02-10",
        "last_updated": "2017-02-10",
        "status": "A",
        "authorized_official_last_name": "STANFIELD",
        "authorized_official_first_name": "KELLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-821-5663"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Denise L West, LMSW
• Jasmine Wilson, LPN
• Wood River Dental Group LLC
• Wood River Hartford SCH Dist 15
• Wood River Healthcare & Rehabilitation Center LLC (Integrity Healthcare of Wood River)
• Wood River NH LLC (Foxes Grove Supporting Living)
• Wood River Retirement Center, Inc (Foxes Grove Supportive Living Community)

• Chiropractor in Wood River, IL
• Providers in Wood River, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2017; 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.