St. Luke'S Chiropractic Health Center LLC

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

2002013828 Issued in MO

Legal business name

ST. LUKE'S CHIROPRACTIC HEALTH CENTER LLC

Practice address

1304 Brenda Ave
Suite B
Perryville, MO 63775-2303

Phone

(573) 547-3113

Fax

(573) 547-1166

NPI assigned

May 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Eric Waltemate, D.C.NPI 1225101876

Title

Owner

Phone

(573) 547-3113

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Eric Neil Waltemate, D.C.

  • Chiropractor
  • Creve Coeur, MO
  • NPI 1225101876
  NPD (past) Authorized official

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1003026170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1304 BRENDA AVE",
            "address_2": "SUITE B",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752303",
            "telephone_number": "573-547-3113",
            "fax_number": "573-547-1166"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1304 BRENDA AVE",
            "address_2": "SUITE B",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752303",
            "telephone_number": "573-547-3113",
            "fax_number": "573-547-1166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ST. LUKE'S CHIROPRACTIC HEALTH CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WALTEMATE",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "573-547-3113",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor, Rehabilitation",
            "state": "MO",
            "license": "2002013828",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM OF MISSOURI",
            "identifier": "163271",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Chiropractor in Perryville, MO
• Providers in Perryville, MO by specialty
• Rehabilitation Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.