Organization Active NPI

Chiro One Wellness Center of Richmond Heights LLC

  • Chiropractor
  • Richmond Heights, MO
National Provider Identifier
1003434994
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
CHIRO ONE WELLNESS CENTER OF RICHMOND HEIGHTS LLC
Practice address
32 The Boulevard Saint Louis
Richmond Heights, MO 63117-1122
Phone
(630) 468-1824
NPI assigned
Jul 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Stuart BernsenNPI 1386691566
Title
Ceo
Phone
(630) 320-6400

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 Primary

Addresses

Primary practice location

32 The Boulevard Saint Louis
Richmond Heights, MO 63117-1122

Mailing address

2625 Butterfield Rd Ste 301N
Oak Brook, IL 60523-1266
Phone (630) 468-1824

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200828002807 MO Part B Supplier - Clinic/Group Practice 9638596158 Receives reassigned benefits from 5 practitioners
Practice locations: Richmond Heights, MO

National Provider Directory

National Provider Directory

Locations

32 The Boulevard Saint Louis
Richmond Heights, MO 63117
Phone (314) 666-6235

Practitioners & affiliated clinicians

Practitioners 6

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": "1594166400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1003434994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2625 BUTTERFIELD RD STE 301N",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231266",
            "telephone_number": "630-468-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32 THE BOULEVARD SAINT LOUIS",
            "city": "RICHMOND HEIGHTS",
            "state": "MO",
            "postal_code": "631171122",
            "telephone_number": "630-468-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIRO ONE WELLNESS CENTER OF RICHMOND HEIGHTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-08",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "BERNSEN",
        "authorized_official_first_name": "STUART",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "630-320-6400"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond Heights, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.