NPIMap

Organization Active NPI

Mestdagh Chiropractic Corp

Doing business as Columbia Chiropractic

  • Chiropractor
  • Columbia, IL
National Provider Identifier
1801192554
Registry record updated Jan 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MESTDAGH CHIROPRACTIC CORP
Doing business as
Columbia Chiropractic
Practice address
1550 N Main St
Columbia, IL 62236-1070
Phone
(618) 281-6167
Fax
(618) 281-4444
NPI assigned
Jan 28, 2011
Last updated
Jan 28, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2011

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

Authorized official

Name
Dr. Laurie Robert Mestdagh, D.C.NPI 1417006859
Title
President
Phone
(618) 281-6167

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

1550 N Main St
Columbia, IL 62236-1070

Mailing address

1550 N Main St
Columbia, IL 62236-1070
Phone (618) 281-6167

Other names 1

  • Columbia Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

1550 N Main St
Columbia, IL 62236
Phone (618) 281-6167

Practitioners & affiliated clinicians

Practitioners 2

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": "1296172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296172800000",
    "number": "1801192554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 N MAIN ST",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361070",
            "telephone_number": "618-281-6167",
            "fax_number": "618-281-4444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 N MAIN ST",
            "city": "COLUMBIA",
            "state": "IL",
            "postal_code": "622361070",
            "telephone_number": "618-281-6167",
            "fax_number": "618-281-4444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MESTDAGH CHIROPRACTIC CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-01-28",
        "last_updated": "2011-01-28",
        "status": "A",
        "authorized_official_last_name": "MESTDAGH",
        "authorized_official_first_name": "LAURIE",
        "authorized_official_middle_name": "ROBERT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "618-281-6167",
        "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": [
        {
            "organization_name": "Columbia Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbia, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.