Individual provider Active NPI

Justin Adam Felsman, D.C.

  • Rehabilitation Chiropractor
  • Quincy, IL
National Provider Identifier
1790066017
Registry record updated Mar 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
2011028781 Issued in MO
Practice address
4440 Broadway St # 12
Quincy, IL 62305-9147
Phone
(217) 242-0420
NPI assigned
Aug 31, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 2011028781 MO Primary

Addresses

Primary practice location

4440 Broadway St # 12
Quincy, IL 62305-9147

Mailing address

4440 Broadway St # 12
Quincy, IL 62305-9147
Phone (217) 242-0420

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120319000728 IL Practitioner - Chiropractic 8921268541

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2011028781MOMDRehabilitation Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Limitless Medical CurrentSince Mar 14, 2023 Accepting new patients

Locations

4440 Broadway St
#12
Quincy, IL 62305
Phone (217) 214-4440

4440 Broadway St
Ste 12
Quincy, IL 62305
Phone (217) 242-0420

Organizations & group practices 2

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": "1314748800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678752000000",
    "number": "1790066017",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4440 BROADWAY ST # 12",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623059147",
            "telephone_number": "217-242-0420"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4440 BROADWAY ST # 12",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623059147",
            "telephone_number": "217-242-0420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FELSMAN",
        "first_name": "JUSTIN",
        "middle_name": "ADAM",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-08-31",
        "last_updated": "2023-03-14",
        "certification_date": "2023-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MO",
            "license": "2011028781",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2023; 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.