NPIMap

Organization Active NPI

Vance Clinic PLLC

Doing business as Vance Clinic of Chiropractic

  • Chiropractor
  • Quincy, IL
National Provider Identifier
1992437438
Registry record updated Jun 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
VANCE CLINIC PLLC
Doing business as
Vance Clinic of Chiropractic
Practice address
1420 S 14TH St
Quincy, IL 62301-6722
Phone
(217) 228-9000
Fax
(217) 228-9001
NPI assigned
Jun 24, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2022

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

Authorized official

Name
Dr. Ryan Miller, DCNPI 1609012178
Title
Owner
Phone
(217) 653-9559

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

1420 S 14TH St
Quincy, IL 62301-6722

Mailing address

1420 S 14TH St
Quincy, IL 62301-6722
Phone (217) 228-9000

Other names 1

  • Vance Clinic of Chiropractic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220715001737 IL Part B Supplier - Clinic/Group Practice 6507247970 Receives reassigned benefits from 2 practitioners
Practice locations: Quincy, IL

National Provider Directory

National Provider Directory

Locations

1420 S 14th St
Quincy, IL 62301
Phone (217) 228-9000

Practitioners & affiliated clinicians

Practitioners 4

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": "1656028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1656028800000",
    "number": "1992437438",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 S 14TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623016722",
            "telephone_number": "217-228-9000",
            "fax_number": "217-228-9001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S 14TH ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623016722",
            "telephone_number": "217-228-9000",
            "fax_number": "217-228-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VANCE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-06-24",
        "last_updated": "2022-06-24",
        "certification_date": "2022-06-17",
        "status": "A",
        "authorized_official_last_name": "MILLER",
        "authorized_official_first_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-653-9559",
        "authorized_official_name_prefix": "Dr.",
        "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": [
        {
            "organization_name": "Vance Clinic of Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Quincy, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; 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.