Progressive Wellness Center

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROGRESSIVE WELLNESS CENTER

Practice address

5220 S 6TH Street Rd
Suite 1500
Springfield, IL 62703-5735

Phone

(217) 529-0300

Fax

(217) 529-2606

NPI assigned

Sep 6, 2007

Last updated

Sep 6, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Nancy McCorkle

Title

Billing MGR

Phone

(217) 585-7910

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189036800000",
    "number": "1821283466",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 S 6TH STREET RD",
            "address_2": "SUITE 1500",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035735",
            "telephone_number": "217-529-0300",
            "fax_number": "217-529-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 S 6TH STREET RD",
            "address_2": "SUITE 1500",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627035735",
            "telephone_number": "217-529-0300",
            "fax_number": "217-529-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROGRESSIVE WELLNESS CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A",
        "authorized_official_last_name": "MCCORKLE",
        "authorized_official_first_name": "NANCY",
        "authorized_official_title_or_position": "BILLING MGR",
        "authorized_official_telephone_number": "217-585-7910"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD OF ILLINOIS",
            "identifier": "8432119",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jerry Priddy, PA-C
• Lynnea Pride
• Kimberly Prince, LCPC
• PRN Homecare Services Inc
• Katelyn R Probst, CSFA
• Anastasia Proshkina
• Angela M Prosise, P.A.
• Tamara Sue Pruetzel, COTA/L
• Ashley Pruitt
• Geralyn Sue Prullage, APN

• Physical Therapy Clinic/Center in Springfield, IL
• Providers in Springfield, IL by specialty
• Physical Therapy Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.