Individual provider Active NPI

William Scott Hallums, D.C.

  • Chiropractor
  • Chesterfield, MO
National Provider Identifier
1053450031
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
038.011112 Issued in IL
Practice address
4 West Dr
Ste 100
Chesterfield, MO 63017-0003
Phone
(636) 536-3622
Fax
(636) 536-2039
NPI assigned
Feb 6, 2007
Last updated
Apr 29, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 038.011112 IL Primary

Addresses

Primary practice location

4 West Dr
Ste 100
Chesterfield, MO 63017-0003

Mailing address

4 West Dr
Ste 100
Chesterfield, MO 63017-0003
Phone (636) 536-3622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210517000636 MO Practitioner - Chiropractic 6709978661 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 W Dr
100 Performance Chiropractic
Chesterfield, MO 63017-0003
Phone (636) 536-3622

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
038.011112ILMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
William S. Hallums, DC LLC Chiropractor CurrentSince Apr 18, 2021 Accepting new patients
Chiropractic Medicine & Associates of Dupage Chiropractor Past Accepting new patients

Locations

4 West Dr
Ste 100
Chesterfield, MO 63017
Phone (636) 386-5001

Networks

  • IA HMO C-SNP
  • IA HMO

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619654400000",
    "number": "1053450031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 WEST DR",
            "address_2": "STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630170003",
            "telephone_number": "636-536-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 WEST DR",
            "address_2": "STE 100",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630170003",
            "telephone_number": "636-536-3622",
            "fax_number": "636-536-2039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLUMS",
        "first_name": "WILLIAM",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IL",
            "license": "038.011112",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chesterfield, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; 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.