Organization Active NPI

Buck Chiropractic, LLC

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1003003476
Registry record updated Jul 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007000246 Issued in MO
Legal business name
BUCK CHIROPRACTIC, LLC
Practice address
8641 Watson Rd
Saint Louis, MO 63119-5109
Phone
(314) 374-2503
NPI assigned
Oct 1, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2014

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

Authorized official

Name
Dr. Matthew J Buck, D.C.NPI 1417162512
Title
Owner
Phone
(314) 962-3130

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 2007000246 MO Primary

Addresses

Primary practice location

8641 Watson Rd
Saint Louis, MO 63119-5109

Mailing address

8641 Watson Rd
Saint Louis, MO 63119-5109
Phone (314) 374-2503

Other names 1

  • Buck Chiropractic Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100628000116 MO Part B Supplier - Clinic/Group Practice 7214068782 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Louis, MO

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1191196800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1405987200000",
    "number": "1003003476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8641 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195109",
            "telephone_number": "314-374-2503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8641 WATSON RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631195109",
            "telephone_number": "314-374-2503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUCK CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-01",
        "last_updated": "2014-07-22",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-962-3130",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007000246",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Buck Chiropractic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2014; 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.