DR. BRIAN DAVID PENWELL (NPI# 1568436624) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568436624 |
| Entity Type | Individual |
| Full Name | DR. BRIAN DAVID PENWELL |
| Credential | D.C. |
| Practice Address |
2 N Country Club Rd Suite 3 Decatur IL 62521-4161 |
| Mailing Address |
3300 Salem School Rd Decatur IL 62521-8853 |
| Practice Telephone | 2174231500 |
| Practice Fax Number | 2174231504 |
| Mailing Telephone | 2178649082 |
| Enumeration Date | 2006-02-15 |
| Last Update Date | 2007-11-30 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | IL | Chiropractic Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BLUECROSS BLUESHIELD | 5806100 | 01 |
| Street Address |
2 N COUNTRY CLUB RD SUITE 3 |
| City | DECATUR |
| State | IL |
| Zip Code | 62521-4161 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831192558 | James Michael Hudson | Dentist | 2 N Country Club Rd, Ste 1, Decatur, IL 62521-4173 | 2005-05-27 |
| 1609114222 | Hillarie Ryann Hudson | Dentist | 2 N Country Club Rd, Suite 1, Decatur, IL 62521-4161 | 2013-01-17 |
| 1962600551 | Karen Lamb | Physical Therapist | 2 N Country Club Rd, Suite 3, Decatur, IL 62521-4161 | 2007-07-05 |
| 1801910062 | Midwest Healthcare Center Sc | Chiropractor | 2 N Country Club Rd, Suite 3, Decatur, IL 62521-4161 | 2007-03-16 |
| 1952375222 | Nancy L Penwell | Chiropractor | 2 N Country Club Rd, Suite 3, Decatur, IL 62521-4161 | 2006-02-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053927988 | Caleb David Braasch | Pharmacist | 1818 South Airport Rd, Decatur, IL 62521 | 2020-09-16 |
| 1295390490 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | Crossing Recovery Center, 495 East Central Ave, Decatur, IL 62521 | 2019-05-03 |
| 1396300638 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 E Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1679138911 | Crossing Recovery Center | Substance Abuse Rehabilitation Facility | 495 East Central Ave, Decatur, IL 62521 | 2019-05-02 |
| 1154848034 | Zack Shaw | Physical Therapist | 4855-57 East 36, Decatur, IL 62521 | 2017-08-23 |
| 1790032852 | Prashant Morolia | Family Medicine | 4775 E Maryland St, Decatur, IL 62521 | 2012-08-08 |
| 1003188913 | Evergreen Place Decatur, LLC | Assisted Living Facility | 4825 E Evergreen Court, Decatur, IL 62521 | 2012-02-08 |
| 1104133099 | Suzette Marie Shafer | Occupational Therapy Assistant | 1790 S. Fairview Ave., Decatur, IL 62521 | 2010-09-13 |
| 1467784090 | Community Health Improvement Center | Clinic/Center | 1221 East Condit Street, Decatur, IL 62521 | 2010-02-08 |
| 1982839056 | Kelly Clark Dds PC | Dentist | 3737 Us Rt 36 E, Decatur, IL 62521 | 2009-05-19 |
| Find all providers in zip 62521 | ||||
| Taxonomy Code | 111N00000X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821621590 | Ericka Gonzalez-mercado | Chiropractor | 301 S Washburn St Ste D, Decatur, TX 76234-1658 | 2020-02-20 |
| 1811531684 | Kealy Olvera | Chiropractor | 3910 Flat Shoals Pkwy, Decatur, GA 30034-7510 | 2019-11-04 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1437700515 | Cara Gilligan | Chiropractor | 409 Mead Rd Unit 3, Decatur, GA 30030-3639 | 2019-09-20 |
| 1164078440 | Jodi K Green | Chiropractor | 2418 Danville Rd Sw Ste C, Decatur, AL 35603-4278 | 2019-08-13 |
| 1134771389 | Keysa Bailey | Chiropractor | 1089 Columbia Dr, Decatur, GA 30030-4728 | 2019-07-09 |
| 1245798545 | Xavier Ortiz Valle | Chiropractor | 1585 Church St Ste 665, Decatur, GA 30033-6059 | 2019-03-05 |
| 1619434388 | Peter William Vercellino | Chiropractor | 3350 N Water St Ste A, Decatur, IL 62526-2353 | 2019-02-28 |
| 1891268439 | Timothy A Peck Dc PC | Chiropractor | 2934 Point Mallard Pkwy Se # B2, Decatur, AL 35603-5700 | 2019-01-07 |
| 1487046066 | Haley Wilkins | Chiropractor | 2605 Danville Rd Sw, Decatur, AL 35603-4216 | 2015-02-19 |
| Find all providers in DECATUR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.