Bloomington-Normal Chiropractic Wellness Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

BLOOMINGTON-NORMAL CHIROPRACTIC WELLNESS CENTER LLC

Practice address

2405 General Electric Rd Ste 3
Bloomington, IL 61704-8597

Phone

(309) 661-2725

Fax

(309) 661-2730

NPI assigned

Jan 22, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Matthew A Morse, D.C.NPI 1326476557

Title

Owner/President

Phone

(309) 661-2725

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 4

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

• Matthew Morse, D.C.

  • Chiropractor
  • Bloomington, IL
  • NPI 1326476557
  Medicare reassignment Care Compare group NPD Authorized official
• Brent J Deshaw, D.C.

  • Chiropractor
  • Brunswick, GA
  • NPI 1922264464

  IL

  Medicare reassignment Care Compare group NPD
• Brianna Shepler, DC

  • Chiropractor
  • Bloomington, IL
  • NPI 1275344038
  Medicare reassignment NPD
• Matthew Morse, CRNA

  • Certified Registered Nurse Anesthetist
  • Lexington, KY
  • NPI 1336673631
  NPD (past)

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1580428800000",
    "number": "1780214486",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 GENERAL ELECTRIC RD STE 3",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048597",
            "telephone_number": "309-661-2725",
            "fax_number": "309-661-2730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 GENERAL ELECTRIC RD STE 3",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617048597",
            "telephone_number": "309-661-2725",
            "fax_number": "309-661-2730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLOOMINGTON-NORMAL CHIROPRACTIC WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-31",
        "certification_date": "2020-01-31",
        "status": "A",
        "authorized_official_last_name": "MORSE",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "309-661-2725",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 31, 2020; 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.