Active NPI
Sara Beth Minnick, D.C.
- Chiropractor
- O Fallon, IL
National Provider Identifier
1912368697
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038012951
- Practice address
- 705 W Highway 50
O Fallon, IL 62269-1900 - Phone
- (618) 624-4242
- Fax
- (618) 624-4248
- NPI assigned
- Mar 9, 2016
- Sex
- Female
- Sole proprietor
- No
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 | 038012951 | IL | Primary |
Addresses
Primary practice location
705 W Highway 50
O Fallon, IL 62269-1900
Mailing address
705 W Highway 50
O Fallon, IL 62269-1900
Phone (618) 624-4242
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1457481600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1457481600000",
"number": "1912368697",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 W HIGHWAY 50",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691900",
"telephone_number": "618-624-4242",
"fax_number": "618-624-4248"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 W HIGHWAY 50",
"city": "O FALLON",
"state": "IL",
"postal_code": "622691900",
"telephone_number": "618-624-4242",
"fax_number": "618-624-4248"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MINNICK",
"first_name": "SARA",
"middle_name": "BETH",
"credential": "D.C.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-09",
"last_updated": "2016-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038012951",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in O Fallon, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.