Organization Active NPI

Tower Grove Chiropractic and Wellness

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1023311867
Registry record updated Dec 17, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007035560 Issued in MO
Legal business name
TOWER GROVE CHIROPRACTIC AND WELLNESS
Practice address
4932 Murdoch Ave
Saint Louis, MO 63109-2943
Phone
(314) 583-8763
Fax
(314) 627-1357
NPI assigned
Dec 17, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2010

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

Authorized official

Name
Dr. Philip Israel Bushman, D.C.
Title
Chiropractic Physician
Phone
(314) 583-8763

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2007035560 MO Primary

Addresses

Primary practice location

4932 Murdoch Ave
Saint Louis, MO 63109-2943

Mailing address

4932 Murdoch Ave
Saint Louis, MO 63109-2943
Phone (314) 583-8763

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1292544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292544000000",
    "number": "1023311867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4932 MURDOCH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092943",
            "telephone_number": "314-583-8763",
            "fax_number": "314-627-1357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4932 MURDOCH AVE",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631092943",
            "telephone_number": "314-583-8763",
            "fax_number": "314-627-1357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWER GROVE CHIROPRACTIC AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-17",
        "last_updated": "2010-12-17",
        "status": "A",
        "authorized_official_last_name": "BUSHMAN",
        "authorized_official_first_name": "PHILIP",
        "authorized_official_middle_name": "ISRAEL",
        "authorized_official_title_or_position": "CHIROPRACTIC PHYSICIAN",
        "authorized_official_telephone_number": "314-583-8763",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007035560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 17, 2010; 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.