Chiropro of Columbia, LLC
Organization Active NPI Chiropractor · Columbia, IL
NPI 1669015228 · NPPES record last updated Jan 17, 2020
Key facts
- NPI
- 1669015228
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- Legal business name
- CHIROPRO OF COLUMBIA, LLC
- Practice address
- 1005 South Main Street
Suite a
Columbia, IL 62236 - Phone
- (618) 719-2350
- NPI assigned
- Oct 25, 2019
- Organization subpart
- No
Authorized official
- Name
- Dr. Robert Brandon Rice, DC
- Title
- Owner
- Phone
- (618) 719-2350
Practitioners 11
-
Jeffrey Allen Williams, D.C.
-
Joseph Westcott Asher, D.C.
-
Sanela Begovic, D.C.
-
Bailey Leitschuh, DC
-
Brandon Trone, DC
-
Robert Brandon Rice, B.S., D.C.
-
Grant Gaspard, DC, ATC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20191119002372 | IL | Part B Supplier - Clinic/Group Practice | 6204268824 |
Receives reassigned benefits from 10 practitioners Practice locations: Columbia, IL |
National Provider Directory
Locations
1005 S Main St
Ste A
Columbia, IL 62236
Phone (618) 234-8300
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | Yes |
Addresses
Primary practice location
1005 South Main Street
Suite a
Columbia, IL 62236
Mailing address
1005 South Main Street
Suite a
Columbia, IL 62236
Phone (618) 979-0398
Other names
- ChiroPro
Other providers in Columbia, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 17, 2020. 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.