Ethan Stanley, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

2023041487 Issued in MO

Practice address

1232 Jungermann Rd
Saint Peters, MO 63376-6963

Phone

(636) 685-0717

NPI assigned

Dec 21, 2023

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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

• Heartstone Missouri LLC

  • Chiropractor
  • Saint Peters, MO
  • NPI 1932933462
  NPD

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

{
    "created_epoch": "1703116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1703116800000",
    "number": "1043089816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 JUNGERMANN RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766963",
            "telephone_number": "636-685-0717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1232 JUNGERMANN RD",
            "city": "SAINT PETERS",
            "state": "MO",
            "postal_code": "633766963",
            "telephone_number": "636-685-0717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANLEY",
        "first_name": "ETHAN",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-21",
        "last_updated": "2023-12-21",
        "certification_date": "2023-12-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2023041487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Peters Cosmetic and Family Dentistry LLC
• St. Peters Manor, Inc.
• St. Peters Orthodontics LLC
• Laurie Stabile, OTR/L
• Courtney Stallis, OTR/L
• Joseph Stanley Jr., PHD
• Cassandra Rochelle Starbuck, M.S. CCC-SLP
• Steadfast Home Healthcare LLC
• Rachelle Lanea Stebe, ATC
• Edward Samuel Stein, DPM

• Chiropractor in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2023; 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.