Individual provider Active NPI

Lance Sterling Rahden, D.C.

  • Chiropractor
  • Greenville, IL
National Provider Identifier
1841563004
Registry record updated Mar 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012197 Issued in IL
Practice address
203 E Main St
Greenville, IL 62246-1810
Phone
(618) 664-3001
Fax
(618) 664-1898
NPI assigned
Feb 20, 2012
Last updated
Mar 28, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2012002891 MO
Chiropractor 111N00000X 038.012197 IL Primary

Addresses

Primary practice location

203 E Main St
Greenville, IL 62246-1810

Mailing address

203 E Main St
Greenville, IL 62246-1810
Phone (618) 664-3001

Other practice location 1

438 Oak Glen Dr
Ballwin, MO 63021-7463
Phone (314) 504-3295

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120820000656 IL Practitioner - Chiropractic 4284881673 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

203 E Main St
Greenville, IL 62246-1810
Phone (618) 664-3001

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012197ILMDChiropractor
2012002891MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Southern Illinois Physicians Group LTD Chiropractor CurrentSince Apr 11, 2018 Accepting new patients
Integrated Medical Group LTD Chiropractor CurrentSince Jan 1, 2015 Accepting new patients
Jerseyville Pain Management Center, S.C. Chiropractor Past Accepting new patients

Locations

203 E Main St
Greenville, IL 62246
Phone (618) 664-3001

811 Broadway
Highland, IL 62249
Phone (618) 654-3900

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": "1329696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522195200000",
    "number": "1841563004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E MAIN ST",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622461810",
            "telephone_number": "618-664-3001",
            "fax_number": "618-664-1898"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 E MAIN ST",
            "city": "GREENVILLE",
            "state": "IL",
            "postal_code": "622461810",
            "telephone_number": "618-664-3001",
            "fax_number": "618-664-1898"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "438 Oak Glen Dr",
            "address_purpose": "LOCATION",
            "city": "Ballwin",
            "state": "MO",
            "postal_code": "630217463",
            "country_code": "US",
            "telephone_number": "314-504-3295",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RAHDEN",
        "first_name": "LANCE",
        "middle_name": "STERLING",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-02-20",
        "last_updated": "2018-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2012002891",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012197",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.