NPIMap

Organization Active NPI

Greater Peoria Physical Medicine & Rehab

Doing business as Joseph & Hishon Chiropractic

  • Chiropractor
  • Peoria, IL
National Provider Identifier
1861618829
Registry record updated Jun 20, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
GREATER PEORIA PHYSICAL MEDICINE & REHAB
Doing business as
Joseph & Hishon Chiropractic
Practice address
5001 N. University Street
Suite a
Peoria, IL 61614
Phone
(309) 693-2225
Fax
(309) 693-2228
NPI assigned
Apr 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2013

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

Authorized official

Name
Amanda J King
Title
Chiropractic Assistant
Phone
(309) 693-2225

Specialties & licenses 1

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

Addresses

Primary practice location

5001 N. University Street
Suite a
Peoria, IL 61614

Mailing address

5001 N. University Street
Suite a
Peoria, IL 61614
Phone (309) 693-2225

Other names 1

  • Joseph & Hishon Chiropractic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20041012001365 IL Part B Supplier - Clinic/Group Practice 5294795472 Receives reassigned benefits from 5 practitioners
Practice locations: Peoria, IL
O20180817000756 IL DME Supplier - Multi-Specialty - PhysicianDME Supplier - Nurse Practitioner 5294795472 Practice locations: Peoria, IL

National Provider Directory

National Provider Directory
Tax ID family
Greater Peoria Physical Medicine Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

5001 N University St
Ste A
Peoria, IL 61614
Phone (309) 683-3072

Practitioners & affiliated clinicians

Practitioners 7

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": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371686400000",
    "number": "1861618829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5001 N. UNIVERSITY STREET",
            "address_2": "SUITE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-693-2225",
            "fax_number": "309-693-2228"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5001 N. UNIVERSITY STREET",
            "address_2": "SUITE A",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "61614",
            "telephone_number": "309-693-2225",
            "fax_number": "309-693-2228"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER PEORIA PHYSICAL MEDICINE & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2013-06-20",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "AMANDA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CHIROPRACTIC ASSISTANT",
        "authorized_official_telephone_number": "309-693-2225"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Joseph & Hishon Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Peoria, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2013; 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.