Shane Ray Acey, DC
Individual provider Active NPI Chiropractor · Festus, MO
NPI 1003519455 · NPPES record last updated May 29, 2024
Key facts
- NPI
- 1003519455
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 2023015283 (MO)
- Practice address
- 1382 YMCA Dr
Festus, MO 63028-2662 - Phone
- (636) 937-7771
- Fax
- (636) 937-7775
- NPI assigned
- Mar 24, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MO
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230818002490 | MO | Practitioner - Chiropractic | 5092177220 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CHR.0008623 | CO | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arbavada Chiropractic and Wellness Center LLC | Chiropractor | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHR.0008623 | CO | |
| Chiropractor | 111N00000X | 2023015283 | MO | Yes |
Addresses
Primary practice location
1382 YMCA Dr
Festus, MO 63028-2662
Mailing address
1382 YMCA Dr
Festus, MO 63028-2662
Phone (636) 937-7771
Other providers in Festus, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.