Robert Matthew Gretencord, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

038-009691 Issued in IL

Practice address

106 W McKinley Rd
Ottawa, IL 61350-4713

Phone

(815) 434-1616

Fax

(815) 434-1625

NPI assigned

Sep 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Specialty

Chiropractic

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Advanced Healthcare Providers, SC

  • General Practice Physician
  • Belvidere, IL
  • NPI 1770839698
  NPD (past)

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

{
    "created_epoch": "1159574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1500422400000",
    "number": "1992898399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "106 W MCKINLEY RD",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613504713",
            "telephone_number": "815-434-1616",
            "fax_number": "815-434-1625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 W MCKINLEY RD",
            "city": "OTTAWA",
            "state": "IL",
            "postal_code": "613504713",
            "telephone_number": "815-434-1616",
            "fax_number": "815-434-1625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRETENCORD",
        "first_name": "ROBERT",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-30",
        "last_updated": "2017-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038-009691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "0001634958",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Goodwine, MD
• Great Heights Medical LTD.
• Great Heights Otp
• Tiffany Reenae Green, RN
• Dontae Greenfield
• Rodney Arthur Griffis, CRNA
• John Christian Grimm
• Gueorgui S Gueorguiev, M.D.
• Raul V Guerrero, MD
• Lisa Kay Gustafson, MS/LCPC

• Chiropractor in Ottawa, IL
• Providers in Ottawa, IL by specialty
• Chiropractor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2017; 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.