Organization Active NPI

Restoration Chiropractic LLC

  • Chiropractor
  • Columbia, MO
National Provider Identifier
1043662570
Registry record updated Mar 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2016017211 Issued in MO
Legal business name
RESTORATION CHIROPRACTIC LLC
Practice address
1413 Grindstone Plaza Dr Ste 109
Columbia, MO 65201-3794
Phone
(573) 476-1000
Fax
(573) 256-7378
NPI assigned
Jul 8, 2016
Last updated
Mar 30, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2021

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

Authorized official

Name
Dr. Taylor John Sirois, DCNPI 1306298930
Title
Owner/Provider
Phone
(573) 476-1000

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2016017211 MO Primary

Addresses

Primary practice location

1413 Grindstone Plaza Dr Ste 109
Columbia, MO 65201-3794

Mailing address

1413 Grindstone Plaza Dr Ste 109
Columbia, MO 65201-3794
Phone (573) 476-1000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20160916002142 MO Part B Supplier - Clinic/Group Practice 6204123334 Receives reassigned benefits from 4 practitioners
Practice locations: Columbia, MO

National Provider Directory

National Provider Directory

Locations

1413 Grindstone Plaza Dr
Columbia, MO 65201

1413 Grindstone Plaza Dr
Ste 109
Columbia, MO 65201
Phone (573) 247-6798

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1467936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1617062400000",
    "number": "1043662570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1413 GRINDSTONE PLAZA DR STE 109",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652013794",
            "telephone_number": "573-476-1000",
            "fax_number": "573-256-7378"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1413 GRINDSTONE PLAZA DR STE 109",
            "city": "COLUMBIA",
            "state": "MO",
            "postal_code": "652013794",
            "telephone_number": "573-476-1000",
            "fax_number": "573-256-7378"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION CHIROPRACTIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-08",
        "last_updated": "2021-03-30",
        "certification_date": "2021-03-30",
        "status": "A",
        "authorized_official_last_name": "SIROIS",
        "authorized_official_first_name": "TAYLOR",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "573-476-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2016017211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbia, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.