Individual provider Active NPI

Kevin Paul Borntreger, D.C.

  • Chiropractor
  • Effingham, IL
National Provider Identifier
1689071359
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038013014 Issued in IL
Practice address
212 N 4TH St
Effingham, IL 62401-3460
Phone
(217) 347-5812
Fax
(217) 347-5818
NPI assigned
Nov 24, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038013014 IL Primary

Addresses

Primary practice location

212 N 4TH St
Effingham, IL 62401-3460

Mailing address

212 N 4TH St
Effingham, IL 62401-3460
Phone (217) 347-5812

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160822000652 IL Practitioner - Chiropractic 1658666227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

212 N 4TH St
Effingham, IL 62401-3460
Phone (217) 347-5812

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038013014ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Precision XP LLC CurrentSince Apr 7, 2017 Accepting new patients
Chiropractic First of Swva Abingdon Past Accepting new patients

Locations

212 N 4th St
Effingham, IL 62401
Phone (217) 347-5812

Organizations & group practices 2

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": "1416787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1689071359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 N 4TH ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013460",
            "telephone_number": "217-347-5812",
            "fax_number": "217-347-5818"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 N 4TH ST",
            "city": "EFFINGHAM",
            "state": "IL",
            "postal_code": "624013460",
            "telephone_number": "217-347-5812",
            "fax_number": "217-347-5818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORNTREGER",
        "first_name": "KEVIN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-11-24",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038013014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Effingham, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.