Active NPI
Blake Andrew Doss, D.C.
- Chiropractor
- Forsyth, IL
National Provider Identifier
1851585731
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 38011008
- Practice address
- 389 W Weaver Rd
Suite 2
Forsyth, IL 62535-9800 - Phone
- (217) 875-7151
- NPI assigned
- Sep 4, 2007
- Last updated
- Oct 28, 2009
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 38011008 | IL | Primary |
Addresses
Primary practice location
389 W Weaver Rd
Suite 2
Forsyth, IL 62535-9800
Mailing address
389 W Weaver Rd
Suite 2
Forsyth, IL 62535-9800
Phone (217) 875-7151
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
| License | State | Type | Specialty |
|---|---|---|---|
| 38011008 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Back Institute, LTD | Chiropractor | Past | Accepting new patients |
Organizations & group practices 1
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": "1188864000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256688000000",
"number": "1851585731",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "389 W WEAVER RD",
"address_2": "SUITE 2",
"city": "FORSYTH",
"state": "IL",
"postal_code": "625359800",
"telephone_number": "217-875-7151"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "389 W WEAVER RD",
"address_2": "SUITE 2",
"city": "FORSYTH",
"state": "IL",
"postal_code": "625359800",
"telephone_number": "217-875-7151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOSS",
"first_name": "BLAKE",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-09-04",
"last_updated": "2009-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "38011008",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forsyth, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.