DR. MICHAEL WAYNE CHILDRESS (NPI# 1518155886) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518155886 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL WAYNE CHILDRESS |
| Credential | D.C. |
| Practice Address |
217 E Broadway Blvd Johnston City IL 62951-1604 |
| Practice Telephone | 6189833900 |
| Practice Fax Number | 6189833900 |
| Mailing Telephone | 6189833900 |
| Mailing Fax Number | 6189833900 |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2009-01-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 111N00000X | Chiropractor | 038011140 | IL | Chiropractic Providers |
| N | 111N00000X | Chiropractor | 2007030809 | MO | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003019167 | Michael Raymond Childress | Physical Therapy Assistant | 2408 E 81st St Ste 300, Tulsa, OK 74137-4200 | 2007-06-07 |
| 1871863829 | Michael Raymond Childress | Physician Assistant | 5005 N Piedras St, El Paso, TX 79920-5001 | 2012-01-09 |
| 1295766418 | Michael H Childress | Radiology | 2041 Georgia Ave Nw, Washington, DC 20060-0001 | 2006-07-05 |
| Street Address |
217 E BROADWAY BLVD |
| City | JOHNSTON CITY |
| State | IL |
| Zip Code | 62951-1604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043222995 | Robert Donald Martin | Chiropractor | 217 E Broadway Blvd, Johnston City, IL 62951-1604 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093230625 | Chrysalis Behavior Services | Behavioral Analyst | 13887 Jeffrey Mine Road, Johnston City, IL 62951 | 2017-08-04 |
| 1144454232 | Ashley Jean Byrley | Licensed Practical Nurse | 14410 Route 37, Johnston City, IL 62951 | 2009-05-05 |
| 1982888343 | Jamie Lynn Fred | Licensed Practical Nurse | 119 Gas Plant Road, Rea Clinic-duquoin, Johnston City, IL 62951 | 2007-12-20 |
| 1053593533 | Christopher Greater Area Rural Health Planning Corporation | Internal Medicine | 14410 Route 37, Johnston City Community Health Center, Johnston City, IL 62951 | 2007-11-27 |
| 1093166845 | Pathway House, Inc. | Assisted Living Facility | 806 W 10th St, Johnston City, IL 62951-1017 | 2016-06-23 |
| 1205907664 | Gary J Bandy | Pharmacist | 905 Grand Ave, Johnston City, IL 62951-1219 | 2006-11-09 |
| 1144355736 | Bandy Drugs | Pharmacy | 905 Grand Ave, Johnston City, IL 62951-1219 | 2007-02-22 |
| 1295020493 | Rachel Adrianne Pauls | Speech-Language Pathologist | 1108 Grand Ave, Johnston City, IL 62951-1229 | 2011-06-15 |
| 1962428516 | Johnston City Medical Clinic, S. C. | Clinic/Center | 201 W Broadway Blvd, Johnston City, IL 62951-1427 | 2006-07-15 |
| 1356342331 | Christa S Pestka | Family Medicine | 14410 Route 37, Johnston City, IL 62951-1427 | 2005-08-02 |
| Find all providers in zip 62951 | ||||
| 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 |
|---|---|---|---|---|
| 1699924373 | Marvel Chiropractic and Wellness Center LLC | Chiropractor | 417 E Broadway Blvd, Johnston City, IL 62951-1608 | 2008-09-17 |
| 1043222995 | Robert Donald Martin | Chiropractor | 217 E Broadway Blvd, Johnston City, IL 62951-1604 | 2006-08-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548861347 | Evan Charles Mojica | Chiropractor | 1803 W State St Ste 150, Geneva, IL 60134-3692 | 2020-11-06 |
| 1407454424 | Mikel Marshall | Chiropractor | 881 S Lorraine Rd Apt 103, Wheaton, IL 60189-6924 | 2020-10-12 |
| 1912505157 | David Anthony Wesdock | Chiropractor | 208 Parkinson St, Normal, IL 61761-3079 | 2020-10-10 |
| 1902403124 | Maranda Joe Humphreys | Chiropractor | 2150 Manchester Rd Ste 100, Wheaton, IL 60187-2474 | 2020-10-01 |
| 1023625654 | Kennedy Nicole Brauer | Chiropractor | 208 Flax Dr Ste 200, Highland, IL 62249-1394 | 2020-09-28 |
| 1649886730 | Simply Wellness Chiropractic, LLC | Chiropractor | 7117 Crimson Ridge Dr Ste 1, Rockford, IL 61107-6213 | 2020-09-23 |
| 1639785330 | Eve Marie Greenwell | Chiropractor | 143 N Henderson St, Mt Zion, IL 62549-1313 | 2020-09-17 |
| 1588279640 | Guadalupe Garcia | Chiropractor | 2745 Maple Ave Ste 2d, Lisle, IL 60532-3231 | 2020-09-14 |
| 1770197774 | Align Services Bloomington Pllc | Chiropractor | 2309 E Empire St Ste 200a, Bloomington, IL 61704-8636 | 2020-09-07 |
| 1881208080 | Christian James Koch | Chiropractor | 5100 N Ravenswood Ave Ste 107, Chicago, IL 60640-1710 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSTON CITY |
| Zip Code | 62951 |
Please comment or provide details below to improve the information on DR. MICHAEL WAYNE CHILDRESS.
| 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.