Individual provider Active NPI

Scott A Becker, DC, FACO

  • Chiropractor
  • Decatur, IL
National Provider Identifier
1669472924
Registry record updated Feb 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038003978 Issued in IL
Practice address
3419 N Woodford St
Decatur, IL 62526-2839
Phone
(217) 875-7388
Fax
(217) 875-5399
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038003978 IL Primary

Addresses

Primary practice location

3419 N Woodford St
Decatur, IL 62526-2839

Mailing address

3419 N Woodford St
Decatur, IL 62526-2839
Phone (217) 875-7388

Other identifiers 2

IdentifierTypeStateIssuer
5845669OtherILBLUE CROSS BLUE SHIELD IL
038003978MedicaidIL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Groves Family Chiropractic Limited Chiropractor CurrentSince May 12, 2018 Accepting new patients

Locations

3419 N Woodford St
Decatur, IL 62526
Phone (217) 864-1253

Organizations & group practices 1

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488240000000",
    "number": "1669472924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3419 N WOODFORD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262839",
            "telephone_number": "217-875-7388",
            "fax_number": "217-875-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3419 N WOODFORD ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262839",
            "telephone_number": "217-875-7388",
            "fax_number": "217-875-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BECKER",
        "first_name": "SCOTT",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DC, FACO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2017-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038003978",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD IL",
            "identifier": "5845669",
            "state": "IL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "038003978",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2017; 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.