Individual provider Active NPI

Ashley Nicole Fauser

  • Chiropractor
  • Pontiac, IL
National Provider Identifier
1720110224
Registry record updated Oct 4, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011234 Issued in IL
Practice address
402 N Plum St
Pontiac, IL 61764-1817
Phone
(815) 844-4631
Fax
(815) 844-1942
NPI assigned
Mar 10, 2007
Last updated
Oct 4, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2166 TN
Chiropractor 111N00000X 038.011234 IL Primary

Addresses

Primary practice location

402 N Plum St
Pontiac, IL 61764-1817

Mailing address

402 N Plum St
Pontiac, IL 61764-1817
Phone (815) 844-4631

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090114000394 IL Practitioner - Chiropractic 1951401645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Livingston County Chiropractic Center LTDGroup PAC ID 6002804937, 4 clinicians

Practice addresses (Care Compare)

402 N Plum St
Pontiac, IL 61764-1817
Phone (815) 844-4631

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011234ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Whole Body Medical Wellness LTD CurrentSince Apr 1, 2017 Accepting new patients
Purelife Chiropractic, PLLC Chiropractor PastSince Apr 2, 2007 Accepting new patients
Kingsport Family Medical Care PLLC Past Accepting new patients
Heartland Chiropractic Clinic of Morton Chiropractor PastSince Apr 1, 2003 Accepting new patients

Locations

402 N Plum St
Pontiac, IL 61764
Phone (815) 844-4631

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1173484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349308800000",
    "number": "1720110224",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 N PLUM ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617641817",
            "telephone_number": "815-844-4631",
            "fax_number": "815-844-1942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 N PLUM ST",
            "city": "PONTIAC",
            "state": "IL",
            "postal_code": "617641817",
            "telephone_number": "815-844-4631",
            "fax_number": "815-844-1942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAUSER",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-10",
        "last_updated": "2012-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TN",
            "license": "2166",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pontiac, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2012; 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.