Organization Active NPI

Kristin E White Chiropractic Care Inc

  • Chiropractor
  • Decatur, IL
National Provider Identifier
1962011825
Registry record updated Jul 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
KRISTIN E WHITE CHIROPRACTIC CARE INC
Practice address
3350 N Water St
Decatur, IL 62526-2353
Phone
(217) 877-2522
Fax
(217) 877-2522
NPI assigned
Jul 27, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2020

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

Authorized official

Name
Kristin E White, DCNPI 1760447361
Title
President
Phone
(217) 877-2522

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

3350 N Water St
Decatur, IL 62526-2353

Mailing address

4607 Mission Dr
Decatur, IL 62526-9268
Phone (217) 775-3931

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200911000509 IL Part B Supplier - Clinic/Group Practice 7012335870 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, IL

National Provider Directory

National Provider Directory

Locations

3350 N Water St
Decatur, IL 62526
Phone (217) 877-2522

Practitioners & affiliated clinicians

Practitioners 1

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": "1595808000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595808000000",
    "number": "1962011825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4607 MISSION DR",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625269268",
            "telephone_number": "217-775-3931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3350 N WATER ST",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625262353",
            "telephone_number": "217-877-2522",
            "fax_number": "217-877-2522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRISTIN E WHITE CHIROPRACTIC CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-27",
        "last_updated": "2020-07-27",
        "certification_date": "2020-07-27",
        "status": "A",
        "authorized_official_last_name": "WHITE",
        "authorized_official_first_name": "KRISTIN",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "217-877-2522",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2020; 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.