Individual provider Active NPI

Rebecca Sioux Eagan, D.C.

  • Chiropractor
  • Carthage, IL
National Provider Identifier
1962760090
Registry record updated Apr 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038012181 Issued in IL
Practice address
524 Buchanan St
Carthage, IL 62321-1307
Phone
(217) 357-2133
NPI assigned
Apr 26, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038012181 IL Primary
Chiropractor 111N00000X 007526 IA

Addresses

Primary practice location

524 Buchanan St
Carthage, IL 62321-1307

Mailing address

524 Buchanan St
Carthage, IL 62321-1307
Phone (217) 357-2133

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120830000739 IL Practitioner - Chiropractic 2062669708 Receives reassigned benefits from 1 practitioner
Practice locations: Carthage, IL

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

524 Buchanan St
Carthage, IL 62321-1307
Phone (217) 357-2133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
007526IAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Eagan Family Chiropractic Chiropractor PastSince May 1, 2014 Accepting new patients

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

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": "1335398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335398400000",
    "number": "1962760090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "524 BUCHANAN ST",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623211307",
            "telephone_number": "217-357-2133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "524 BUCHANAN ST",
            "city": "CARTHAGE",
            "state": "IL",
            "postal_code": "623211307",
            "telephone_number": "217-357-2133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EAGAN",
        "first_name": "REBECCA",
        "middle_name": "SIOUX",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-26",
        "last_updated": "2012-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038012181",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IA",
            "license": "007526",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carthage, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 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.