Edgar Everett III, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2006022760 Issued in MO

Practice address

2050 Woodson Rd
Ste #101
Overland, MO 63114-5644

Phone

(314) 713-1656

Fax

(314) 395-0607

NPI assigned

May 2, 2006

Last updated

Sep 9, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Proficient Chiropractic West EndGroup PAC ID 5294246773, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Networks

• devoted network organization-2b183dd2-4e80-4977-80a6-4fdf0df4361d
• IA HMO C-SNP
• IA HMO

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Proficient Chiropractic LLC

  • Chiropractor
  • Saint Louis, MO
  • NPI 1124194428
  Medicare reassignment NPD Authorized official
• Proficient Chiropractic West End

  • Chiropractor
  • Saint Louis, MO
  • NPI 1093585226
  Medicare reassignment Care Compare group NPD
• Proficient Chiropractic Holdings LLC

  • Chiropractor
  • Saint Louis, MO
  • NPI 1821429077
  Authorized official Same address or phone
• Proficient Wellness LLC

  • Family Medicine Physician
  • Overland, MO
  • NPI 1992305007
  NPD (past) Authorized official

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

{
    "created_epoch": "1146528000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220918400000",
    "number": "1033177746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 WOODSON RD",
            "address_2": "STE #101",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "631145644",
            "telephone_number": "314-713-1656",
            "fax_number": "314-395-0607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 WOODSON RD",
            "address_2": "STE #101",
            "city": "OVERLAND",
            "state": "MO",
            "postal_code": "631145644",
            "telephone_number": "314-713-1656",
            "fax_number": "314-395-0607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVERETT",
        "first_name": "EDGAR",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-02",
        "last_updated": "2008-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2006022760",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "200250",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Kyla Evans
• Lisha Ewing, LPC
• Sheryl Filker
• Tachayla Fisher-Lester, RBT
• Kendra Karmel Fitzgerald
• Fourroux Prosthetics, Inc

• Chiropractor in Overland, MO
• Providers in Overland, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.