NPIMap

Organization Active NPI

Richard M. Novak, DC PC

  • Rehabilitation Chiropractor
  • Maryville, IL
National Provider Identifier
1992854814
Registry record updated Aug 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
Legal business name
RICHARD M. NOVAK, DC PC
Practice address
4A Oak Dr
Maryville, IL 62062-5809
Phone
(618) 288-8075
NPI assigned
Jan 9, 2007
Last updated
Aug 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2008

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

Authorized official

Name
Dr. Richard Michael Novak, D.C.NPI 1083619449
Title
President / Owner
Phone
(618) 288-8075

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111NR0400X Primary

Addresses

Primary practice location

4A Oak Dr
Maryville, IL 62062-5809

Mailing address

4A Oak Dr
Maryville, IL 62062-5809
Phone (618) 288-8075

National Provider Directory

National Provider Directory

Locations

4 Oak Dr
Ste A
Maryville, IL 62062
Phone (618) 288-8075

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1168300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217894400000",
    "number": "1992854814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4A OAK DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625809",
            "telephone_number": "618-288-8075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4A OAK DR",
            "city": "MARYVILLE",
            "state": "IL",
            "postal_code": "620625809",
            "telephone_number": "618-288-8075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD M. NOVAK, DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-09",
        "last_updated": "2008-08-05",
        "status": "A",
        "authorized_official_last_name": "NOVAK",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT / OWNER",
        "authorized_official_telephone_number": "618-288-8075",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.