Active NPI
John Thomas Reynolds, D.C.
- Chiropractor
- Freeport, IL
National Provider Identifier
1922094119
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 038009341
- Practice address
- 630 Terra West Dr
Freeport, IL 61032-4536 - Phone
- (815) 235-7858
- Fax
- (815) 235-7913
- NPI assigned
- Sep 22, 2005
- 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 | 038009341 | IL | Primary |
Addresses
Primary practice location
630 Terra West Dr
Freeport, IL 61032-4536
Mailing address
630 Terra West Dr
Freeport, IL 61032-4536
Phone (815) 235-7858
Other identifiers 5
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5979340 | Other | IL | CIGNA |
| 004932381 | Other | IL | BC/BS |
| 2017038 | Other | IL | FIRST HEALTH |
| 7531336 | Other | IL | AETNA - PPO |
| 3474535 | Other | IL | AETNA - HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IL
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
630 Terra W Dr
Freeport, IL 61032-4536
Phone (815) 235-7858
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 038009341 | IL | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hulsebus and Gehlsen Chiropractic | Chiropractor | Current | Accepting new patients |
| Strelcheck Chiropractic Clinic LTD | Chiropractor | Past | Accepting new patients |
Locations
630 Terra West Dr
Freeport, IL 61032
Phone (815) 235-7858
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Chiropractor
- Freeport, IL
- NPI 1043433162
-
- Chiropractor
- Crystal Lake, IL
- NPI 1881791945
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127347200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353974400000",
"number": "1922094119",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "630 TERRA WEST DR",
"city": "FREEPORT",
"state": "IL",
"postal_code": "610324536",
"telephone_number": "815-235-7858",
"fax_number": "815-235-7913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "630 TERRA WEST DR",
"city": "FREEPORT",
"state": "IL",
"postal_code": "610324536",
"telephone_number": "815-235-7858",
"fax_number": "815-235-7913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REYNOLDS",
"first_name": "JOHN",
"middle_name": "THOMAS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-09-22",
"last_updated": "2012-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IL",
"license": "038009341",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "5979340",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BC/BS",
"identifier": "004932381",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "2017038",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA - PPO",
"identifier": "7531336",
"state": "IL"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA - HMO",
"identifier": "3474535",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Freeport, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2012; 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.