Individual provider Active NPI

Kylie Danielle Sharp, DC

  • Chiropractor
  • Creve Coeur, MO
National Provider Identifier
1053808568
Registry record updated Apr 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2018003108 Issued in MO
Practice address
12401 Olive Blvd Ste 103
Creve Coeur, MO 63141-5448
Phone
(314) 439-0777
NPI assigned
Apr 19, 2018
Last updated
Apr 19, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2018003108 MO Primary

Addresses

Primary practice location

12401 Olive Blvd Ste 103
Creve Coeur, MO 63141-5448

Mailing address

309 Clayton Crossing PL Apt a
Ellisville, MO 63011-3364

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2018003108MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Ahr Chiropractor CurrentSince Sep 28, 2021 Accepting new patients

Locations

247 E Watt St
Alcoa, TN 37701
Phone (865) 984-2001

Organizations & group practices 1

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": "1524096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524096000000",
    "number": "1053808568",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 CLAYTON CROSSING PL APT A",
            "city": "ELLISVILLE",
            "state": "MO",
            "postal_code": "630113364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12401 OLIVE BLVD STE 103",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631415448",
            "telephone_number": "314-439-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHARP",
        "first_name": "KYLIE",
        "middle_name": "DANIELLE",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-19",
        "last_updated": "2018-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2018003108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 19, 2018; 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.