Individual provider Active NPI

Jeremy Eugene Meyer, D.C.

  • Chiropractor
  • Sycamore, IL
National Provider Identifier
1922360452
Registry record updated Jun 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.012004 Issued in IL
Practice address
1680 Mediterranean Dr
Suite 101
Sycamore, IL 60178-3142
Phone
(815) 899-6061
Fax
(815) 899-7573
NPI assigned
Jun 11, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.012004 IL Primary

Addresses

Primary practice location

1680 Mediterranean Dr
Suite 101
Sycamore, IL 60178-3142

Mailing address

1680 Mediterranean Dr
Suite 101
Sycamore, IL 60178-3142
Phone (815) 899-6061

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140523001227 IA Practitioner - Chiropractic 7517117732 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2010
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1129 6TH St
Nevada, IA 50201-1827
Phone (515) 382-2225

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.012004ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Meyer Chiropractic PC Chiropractor CurrentSince Feb 23, 2016 Accepting new patients
Sycamore Service Corporation Chiropractor PastSince Sep 15, 2004 Accepting new patients

Locations

1129 6th St
Nevada, IA 50201
Phone (515) 382-2225

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.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1339372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339372800000",
    "number": "1922360452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1680 MEDITERRANEAN DR",
            "address_2": "SUITE 101",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783142",
            "telephone_number": "815-899-6061",
            "fax_number": "815-899-7573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 MEDITERRANEAN DR",
            "address_2": "SUITE 101",
            "city": "SYCAMORE",
            "state": "IL",
            "postal_code": "601783142",
            "telephone_number": "815-899-6061",
            "fax_number": "815-899-7573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEYER",
        "first_name": "JEREMY",
        "middle_name": "EUGENE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-11",
        "last_updated": "2012-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.012004",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sycamore, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.

Verify at the official NPI Registry.