Organization Active NPI

James Kofoid Chiropractic, L.L.C.

  • Chiropractor
  • Rockford, IL
National Provider Identifier
1750672671
Registry record updated Nov 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.008132 Issued in IL
Legal business name
JAMES KOFOID CHIROPRACTIC, L.L.C.
Practice address
3806 E State St Ste 101
Rockford, IL 61108-2057
Phone
(815) 978-6219
Fax
(815) 397-7628
NPI assigned
Apr 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2022

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

Authorized official

Name
Dr. James P. Kofoid, D.C.NPI 1679745574
Title
Chiropractor
Phone
(815) 978-6219

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
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 038.008132 IL Primary

Addresses

Primary practice location

3806 E State St Ste 101
Rockford, IL 61108-2057

Mailing address

3806 E State St Ste 101
Rockford, IL 61108-2057
Phone (815) 978-6219

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20110518000671 IL Part B Supplier - Clinic/Group Practice 1658557186 Receives reassigned benefits from 1 practitioner
Practice locations: Rockford, IL

National Provider Directory

National Provider Directory

Locations

1752 Windsor Rd
Ste 104
Loves Park, IL 61111
Phone (815) 282-2323

7115 Windsor Lake Pkwy
Ste 260
Loves Park, IL 61111
Phone (815) 282-2323

3806 E State St
Ste 101
Rockford, IL 61108
Phone (815) 397-2948

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1303776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667865600000",
    "number": "1750672671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3806 E STATE ST STE 101",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082057",
            "telephone_number": "815-978-6219",
            "fax_number": "815-397-7628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3806 E STATE ST STE 101",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611082057",
            "telephone_number": "815-978-6219",
            "fax_number": "815-397-7628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JAMES KOFOID CHIROPRACTIC, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-26",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A",
        "authorized_official_last_name": "KOFOID",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "CHIROPRACTOR",
        "authorized_official_telephone_number": "815-978-6219",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.008132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.