Individual provider Active NPI

Amy C Whitlock

  • Chiropractor
  • Shiloh, IL
National Provider Identifier
1982169033
Registry record updated Dec 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.013323 Issued in IL
Practice address
1231 Thouvenot LN
Shiloh, IL 62269-7203
Phone
(618) 234-8300
NPI assigned
Feb 4, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.013323 IL Primary

Addresses

Primary practice location

1231 Thouvenot LN
Shiloh, IL 62269-7203

Mailing address

1956 Schoettler Valley Dr
Chesterfield, MO 63017-5204
Phone (636) 290-1783

Other practice location 1

1231 Thouvenot Ln
Shiloh, IL 62269-7203
Phone (618) 234-8300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200414000677 MO Practitioner - Chiropractic 6901145929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tiger Family Chiropractic and Wellness CenterGroup PAC ID 1153420674, 3 clinicians

Practice addresses (Care Compare)

2900 Falling Leaf LN
Suite 101
Columbia, MO 65201-6397
Phone (573) 443-1414

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.013323ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tiger Family Chiropractic and Wellness Center Chiropractor CurrentSince Jul 1, 2024 Accepting new patients

Locations

2900 Falling Leaf Ln
Ste 101
Columbia, MO 65201
Phone (573) 256-4713

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": "1549238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1982169033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1956 SCHOETTLER VALLEY DR",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630175204",
            "telephone_number": "636-290-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1231 THOUVENOT LN",
            "city": "SHILOH",
            "state": "IL",
            "postal_code": "622697203",
            "telephone_number": "618-234-8300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1231 Thouvenot Ln",
            "address_purpose": "LOCATION",
            "city": "Shiloh",
            "state": "IL",
            "postal_code": "622697203",
            "country_code": "US",
            "telephone_number": "618-234-8300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WHITLOCK",
        "first_name": "AMY",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-04",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.013323",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shiloh, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.