Individual provider Active NPI

Jeff Lee Davie, D.C.

  • Chiropractor
  • Edwardsville, IL
National Provider Identifier
1831185818
Registry record updated Oct 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038011166 Issued in IL
Practice address
1181 S State Route 157
Suite 200C
Edwardsville, IL 62025-3710
Phone
(618) 288-4100
Fax
(618) 307-3283
NPI assigned
Sep 23, 2005
Last updated
Oct 29, 2009By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X CE006572 MO
Chiropractor 111N00000X 038011166 IL Primary

Addresses

Primary practice location

1181 S State Route 157
Suite 200C
Edwardsville, IL 62025-3710

Mailing address

916 Talon Dr
Suite 102
O Fallon, IL 62269-1848
Phone (618) 628-8211

Other identifiers 3

IdentifierTypeStateIssuer
900068033OtherILHEALTHLINK
900068033OtherILBCBS
900068033OtherILESSENCE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CE006572MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Twin City Healt Services Past Accepting new patients
Associated Physicians Group LTD Past Accepting new patients
Pain Management Partners LLC Past Accepting new patients

Organizations & group practices 3

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1256774400000",
    "number": "1831185818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 TALON DR",
            "address_2": "SUITE 102",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622691848",
            "telephone_number": "618-628-8211",
            "fax_number": "618-628-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1181 S STATE ROUTE 157",
            "address_2": "SUITE 200C",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620253710",
            "telephone_number": "618-288-4100",
            "fax_number": "618-307-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIE",
        "first_name": "JEFF",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-23",
        "last_updated": "2009-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "CE006572",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038011166",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "900068033",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "900068033",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ESSENCE",
            "identifier": "900068033",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Edwardsville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2009; 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.