Organization Active NPI

Nobbe Family Chiropractic, Inc.

  • Chiropractor
  • Maryville, IL
National Provider Identifier
1669776142
Registry record updated Dec 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
NOBBE FAMILY CHIROPRACTIC, INC.
Practice address
2136 Vadalabene Dr Ste B
Maryville, IL 62062-5828
Phone
(618) 288-5091
Fax
(618) 205-3598
NPI assigned
Dec 27, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2023

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

Authorized official

Name
Dr. Kristin E Nobbe-Bloemer, D.C.NPI 1841206935
Title
Owner
Phone
(618) 288-5091

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

2136 Vadalabene Dr Ste B
Maryville, IL 62062-5828

Mailing address

2136 Vadalabene Dr Ste B
Maryville, IL 62062-5828
Phone (618) 288-5091

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110216000385 IL Part B Supplier - Clinic/Group Practice 2567642051 Receives reassigned benefits from 1 practitioner
Practice locations: Maryville, IL

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1293408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701475200000",
    "number": "1669776142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2136 VADALABENE DR STE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625828",
            "telephone_number": "618-288-5091",
            "fax_number": "618-205-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2136 VADALABENE DR STE B",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625828",
            "telephone_number": "618-288-5091",
            "fax_number": "618-205-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOBBE FAMILY CHIROPRACTIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-27",
        "last_updated": "2023-12-02",
        "certification_date": "2023-12-02",
        "status": "A",
        "authorized_official_last_name": "NOBBE-BLOEMER",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "618-288-5091",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2023; 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.