Individual provider Active NPI

Bethany R Meeks, D.C.

  • Chiropractor
  • Fairfield, IL
National Provider Identifier
1750651089
Registry record updated Jan 3, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012107 Issued in IL
Practice address
1111 W Delaware St
Fairfield, IL 62837-2315
Phone
(618) 842-6086
Fax
(618) 842-6086
NPI assigned
Jan 3, 2012
Last updated
Jan 3, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 3, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012107 IL Primary

Addresses

Primary practice location

1111 W Delaware St
Fairfield, IL 62837-2315

Mailing address

1111 W Delaware St
Fairfield, IL 62837-2315

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120302000172 IL Practitioner - Chiropractic 9133388671 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1111 W Delaware St
Fairfield, IL 62837-2315
Phone (618) 842-6086

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012107ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Fairfield Chiropractic Clinic LLC Chiropractor CurrentSince Apr 13, 2015 Accepting new patients

Locations

1111 W Delaware St
Fairfield, IL 62837
Phone (618) 842-6086

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, 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": "1325548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1325548800000",
    "number": "1750651089",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 W DELAWARE ST",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628372315"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 W DELAWARE ST",
            "city": "FAIRFIELD",
            "state": "IL",
            "postal_code": "628372315",
            "telephone_number": "618-842-6086",
            "fax_number": "618-842-6086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEKS",
        "first_name": "BETHANY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-03",
        "last_updated": "2012-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012107",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 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.