Organization Active NPI

Barnewolt & Barnewolt Chiropractic PC

  • Chiropractor
  • Edwards, IL
National Provider Identifier
1730417650
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BARNEWOLT & BARNEWOLT CHIROPRACTIC PC
Practice address
7814 N Kickapoo Edwards Rd
Suite a
Edwards, IL 61528-9564
Phone
(309) 691-6920
Fax
(309) 691-6921
NPI assigned
Dec 4, 2009
Last updated
Mar 16, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Authorized official

Name
Joshua A Barnewolt, DCNPI 1871820902
Title
President
Phone
(309) 691-6920

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
Chiropractor 111N00000X NU Primary

Addresses

Primary practice location

7814 N Kickapoo Edwards Rd
Suite a
Edwards, IL 61528-9564

Mailing address

PO Box 54
Edwards, IL 61528-0054
Phone (309) 691-6920

Other identifiers 1

IdentifierTypeStateIssuer
7232266OtherILBCBS OF IL GROUP

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100301000027 IL Part B Supplier - Clinic/Group Practice 6709921976 Receives reassigned benefits from 2 practitioners
Practice locations: Edwards, IL

National Provider Directory

National Provider Directory

Locations

7814 N Kickapoo Edwards Rd
Ste A
Edwards, IL 61528
Phone (309) 691-6920

9927 W US Highway 150
Edwards, IL 61528
Phone (309) 691-6920

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1259884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1730417650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 54",
            "city": "EDWARDS",
            "state": "IL",
            "postal_code": "615280054",
            "telephone_number": "309-691-6920",
            "fax_number": "309-691-6921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7814 N KICKAPOO EDWARDS RD",
            "address_2": "SUITE A",
            "city": "EDWARDS",
            "state": "IL",
            "postal_code": "615289564",
            "telephone_number": "309-691-6920",
            "fax_number": "309-691-6921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARNEWOLT & BARNEWOLT CHIROPRACTIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-04",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "BARNEWOLT",
        "authorized_official_first_name": "JOSHUA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-691-6920",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF IL GROUP",
            "identifier": "7232266",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwards, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.