NPIMap

Organization Active NPI

First Choice Healthcare and Physical Medicine SC

Doing business as First Choice Healthcare and Physical Medicine

  • Chiropractor
  • Lincoln, IL
National Provider Identifier
1760712350
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.007886 Issued in IL
Legal business name
FIRST CHOICE HEALTHCARE AND PHYSICAL MEDICINE SC
Doing business as
First Choice Healthcare and Physical Medicine
Practice address
714 N Logan St
Lincoln, IL 62656-1741
Phone
(217) 732-1111
Fax
(217) 735-2744
NPI assigned
Jan 5, 2010
Last updated
Oct 20, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Authorized official

Name
Dr. Damon Paul Walton, DCNPI 1518297100
Title
Director
Phone
(217) 732-1111

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 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038.007869 IL
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X 038.007886 IL Primary
Medical Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363AM0700X

Addresses

Primary practice location

714 N Logan St
Lincoln, IL 62656-1741

Mailing address

714 N Logan St
Lincoln, IL 62656-1741
Phone (217) 732-1111

Other names 1

  • First Choice Healthcare and Physical Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100508000138 IL Part B Supplier - Clinic/Group Practice 1355479544 Receives reassigned benefits from 1 practitioner
Practice locations: Lincoln, IL

National Provider Directory

National Provider Directory

Locations

1625 N Union St
Lincoln, IL 62656
Phone (217) 732-1111

714 N Logan St
Lincoln, IL 62656
Phone (217) 732-1111

Practitioners & affiliated clinicians

Practitioners 3

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": "1262649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319068800000",
    "number": "1760712350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 N LOGAN ST",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626561741",
            "telephone_number": "217-732-1111",
            "fax_number": "217-735-2744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 N LOGAN ST",
            "city": "LINCOLN",
            "state": "IL",
            "postal_code": "626561741",
            "telephone_number": "217-732-1111",
            "fax_number": "217-735-2744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIRST CHOICE HEALTHCARE AND PHYSICAL MEDICINE SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-05",
        "last_updated": "2011-10-20",
        "status": "A",
        "authorized_official_last_name": "WALTON",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "217-732-1111",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.007869",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.007886",
            "primary": true
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "First Choice Healthcare and Physical Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lincoln, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 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.