Jacob Daniel Briegleb, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2017031981 Issued in MO

Practice address

560 Old Smizer Mill Rd
Fenton, MO 63026-3538

Phone

(636) 492-1528

Fax

(314) 597-6565

NPI assigned

Sep 28, 2017

Last updated

Jun 26, 2024By 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

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Revival Chiropractic LLCGroup PAC ID 0547500993, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• 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.

• Revival Chiropractic LLC

  • Chiropractor
  • Fenton, MO
  • NPI 1033673389
  Medicare reassignment Care Compare group NPD
• Healthy Healing Chiropractic LLC

  • Point of Service
  • Wildwood, MO
  • NPI 1639438260
  NPD (past)

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719360000000",
    "number": "1033628441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 OLD SMIZER MILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263538",
            "telephone_number": "636-492-1528",
            "fax_number": "314-597-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 OLD SMIZER MILL RD",
            "city": "FENTON",
            "state": "MO",
            "postal_code": "630263538",
            "telephone_number": "636-492-1528",
            "fax_number": "314-597-6565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIEGLEB",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-28",
        "last_updated": "2024-06-26",
        "certification_date": "2024-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2017031981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence Vincent Boveri, MD
• Stephen Angelo Boveri, MD
• Michelle E Braun, RN BSN
• Amanda Nicole Breedlove, PNP
• Brian K Kindel OD PC
• Lindsey N Bright, CRNA
• Brookwood LLC
• Allison Kate Brown, FNP
• Kevin Eugene Bruce, RPH
• Kelsey Janet Brusati

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2024; 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.