Durham Chiropractic, P.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-010457 Issued in IL

Legal business name

DURHAM CHIROPRACTIC, P.C.

Practice address

2175 Route 29 North
Edinburg, IL 62531

Phone

(217) 623-4505

NPI assigned

Nov 13, 2006

Last updated

Aug 18, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. David Grant DurhamNPI 1609970151

Title

President

Phone

(217) 623-4505

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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.

• David Grant Durham, D.C.

  • Chiropractor
  • Edinburg, IL
  • NPI 1609970151
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313625600000",
    "number": "1750452793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 303",
            "city": "EDINBURG",
            "state": "IL",
            "postal_code": "625310303",
            "telephone_number": "217-623-4505",
            "fax_number": "217-623-4506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2175 ROUTE 29 NORTH",
            "city": "EDINBURG",
            "state": "IL",
            "postal_code": "62531",
            "telephone_number": "217-623-4505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DURHAM CHIROPRACTIC, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-08-18",
        "status": "A",
        "authorized_official_last_name": "DURHAM",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-623-4505",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-010457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "95-0-A1-5058-0",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Grant Durham, D.C.
• Deborah Ann Durham, RD
• Edinburg Community Unit School Dist. #4

• Chiropractor in Edinburg, IL
• Providers in Edinburg, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2011; 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.