Individual provider Active NPI

Michael Scott Unnerstall, DC

  • Chiropractor
  • Ballwin, MO
National Provider Identifier
1043210222
Registry record updated Oct 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
006570 Issued in MO
Practice address
15945 Clayton Rd Ste 230C
Ballwin, MO 63011-2491
Phone
(636) 256-5200
NPI assigned
Jul 28, 2005
Last updated
Oct 5, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 5, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 006570 MO Primary

Addresses

Primary practice location

15945 Clayton Rd Ste 230C
Ballwin, MO 63011-2491

Mailing address

1503 Zero Ave
Washington, MO 63090-4714
Phone (636) 239-0037

Other practice location 1

12700 Southfork Rd Ste 155
Saint Louis, MO 63128-3276
Phone (314) 525-4915

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040923000871 MO Practitioner - Chiropractic 2567359946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mercy Hospital SouthGroup PAC ID 8426962556, 45 clinicians
Mercy Hospitals East CommunitiesGroup PAC ID 1658276811, 92 clinicians

Practice addresses (Care Compare)

10010 Kennerly Rd
Saint Louis, MO 63128-2106
Phone (314) 525-1906

10050 Kennerly Rd
Suite 2700
Saint Louis, MO 63128-2106
Phone (314) 525-4250

15945 Clayton Rd
Suite 230
Ballwin, MO 63011-2490
Phone (636) 256-5200

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006570MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Hospital South CurrentSince Aug 17, 2020 Accepting new patients
Mercy Hospital South CurrentSince Aug 17, 2020 Accepting new patients
Mercy Hospitals East Communities Chiropractor CurrentSince Dec 11, 2006 Accepting new patients
Mercy Hospitals East Communities CurrentSince Dec 11, 2006 Accepting new patients
Logan University Chiropractor PastSince Jun 1, 2005 Accepting new patients
Mercy Hospitals East Communities Past Accepting new patients
Gray Family Chiropractic PLLC Chiropractor Past Accepting new patients

Locations

15945 Clayton Rd
Ste 230
Ballwin, MO 63011
Phone (636) 256-5200

15945 Clayton Rd
Ste 230C
Ballwin, MO 63011
Phone (636) 256-5200

10010 Kennerly Rd
Saint Louis, MO 63128
Phone (314) 525-1328

12700 Southfork Rd
Ste 155
Saint Louis, MO 63128
Phone (314) 525-4915

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

Networks

  • IA HMO C-SNP
  • IA HMO

Interoperability endpoints

  • Direct secure messaging: munnerstall92987@directc.mercy.net

Organizations & group practices 7

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696464000000",
    "number": "1043210222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 ZERO AVE",
            "city": "WASHINGTON",
            "state": "MO",
            "postal_code": "630904714",
            "telephone_number": "636-239-0037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15945 CLAYTON RD STE 230C",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630112491",
            "telephone_number": "636-256-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12700 Southfork Rd Ste 155",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631283276",
            "country_code": "US",
            "telephone_number": "314-525-4915",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "UNNERSTALL",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2023-10-05",
        "certification_date": "2023-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "006570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ballwin, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2023; 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.