Individual provider Active NPI

Terry Reed Custer, D.C.

  • Chiropractor
  • Decatur, IL
National Provider Identifier
1679668693
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Practice address
1390 N Fairview Ave
Decatur, IL 62526-3618
Phone
(217) 423-4070
Fax
(217) 423-8325
NPI assigned
Oct 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X IL Primary

Addresses

Primary practice location

1390 N Fairview Ave
Decatur, IL 62526-3618

Mailing address

1390 N Fairview Ave
Decatur, IL 62526-3618
Phone (217) 423-4070

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

State licenses

LicenseStateTypeSpecialty
038-003736ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Korwitts Chiropractic PC Chiropractor PastSince Mar 1, 2005 Accepting new patients

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": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679668693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 N FAIRVIEW AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263618",
            "telephone_number": "217-423-4070",
            "fax_number": "217-423-8325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 N FAIRVIEW AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263618",
            "telephone_number": "217-423-4070",
            "fax_number": "217-423-8325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "TERRY",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 8, 2007; 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.