NPIMap

Organization Active NPI

Birdsell Chiropractic & Acupuncture Clinic, Chartered

  • Chiropractor
  • Moline, IL
National Provider Identifier
1831292457
Registry record updated Mar 20, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
BIRDSELL CHIROPRACTIC & ACUPUNCTURE CLINIC, CHARTERED
Practice address
1201 5TH Avenue
Moline, IL 61265-1331
Phone
(309) 764-8821
Fax
(309) 757-4773
NPI assigned
Sep 7, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2008

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

Authorized official

Name
Dr. David R Birdsell, DCNPI 1568565182
Title
President
Phone
(309) 764-8821

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X IL Primary

Addresses

Primary practice location

1201 5TH Avenue
Moline, IL 61265-1331

Mailing address

1201 5TH Avenue
Moline, IL 61265-1331
Phone (309) 764-8821

Other identifiers 1

IdentifierTypeStateIssuer
8182020OtherILBLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071121000320 IL Part B Supplier - Clinic/Group Practice 3476641606 Receives reassigned benefits from 3 practitioners
Practice locations: Moline, IL

National Provider Directory

National Provider Directory

Locations

1201 5th Ave
Moline, IL 61265
Phone (309) 764-8821

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205971200000",
    "number": "1831292457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 5TH AVENUE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651331",
            "telephone_number": "309-764-8821",
            "fax_number": "309-757-4773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 5TH AVENUE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612651331",
            "telephone_number": "309-764-8821",
            "fax_number": "309-757-4773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BIRDSELL CHIROPRACTIC & ACUPUNCTURE CLINIC, CHARTERED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2008-03-20",
        "status": "A",
        "authorized_official_last_name": "BIRDSELL",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "309-764-8821",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8182020",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Moline, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2008; 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.