Individual provider Active NPI

Kristin E White, D.C.

  • Chiropractor
  • Forsyth, IL
National Provider Identifier
1760447361
Registry record updated Oct 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038010237 Issued in IL
Practice address
389 W Weaver Rd
Suite 2
Forsyth, IL 62535-9791
Phone
(217) 875-7151
Fax
(217) 876-5395
NPI assigned
Apr 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038010237 IL Primary

Addresses

Primary practice location

389 W Weaver Rd
Suite 2
Forsyth, IL 62535-9791

Mailing address

389 W Weaver Rd
Suite 2
Forsyth, IL 62535-9791
Phone (217) 875-7151

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20041112000269 IL Practitioner - Chiropractic 6406818301 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3350 N Water St
Decatur, IL 62526-2353
Phone (217) 877-2522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Kristin E White Chiropractic Care Inc Chiropractor CurrentSince Aug 31, 2020 Accepting new patients

Locations

3350 N Water St
Decatur, IL 62526
Phone (217) 877-2522

3350 N Water St
Ste A
Decatur, IL 62526
Phone (217) 520-4433

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191888000000",
    "number": "1760447361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "389 W WEAVER RD",
            "address_2": "SUITE 2",
            "city": "FORSYTH",
            "state": "IL",
            "postal_code": "625359791",
            "telephone_number": "217-875-7151",
            "fax_number": "217-876-5395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "389 W WEAVER RD",
            "address_2": "SUITE 2",
            "city": "FORSYTH",
            "state": "IL",
            "postal_code": "625359791",
            "telephone_number": "217-875-7151",
            "fax_number": "217-876-5395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITE",
        "first_name": "KRISTIN",
        "middle_name": "E",
        "name_prefix": "Mrs.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-18",
        "last_updated": "2007-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038010237",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forsyth, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2007; 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.