Organization Active NPI

Chiropractic of North County, LLC

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1063872893
Registry record updated Mar 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2002014997 Issued in MO
Legal business name
CHIROPRACTIC OF NORTH COUNTY, LLC
Practice address
10111 Lewis and Clark Blvd
Saint Louis, MO 63136-5562
Phone
(314) 867-8888
NPI assigned
Mar 7, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2016

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

Authorized official

Name
Dr. Mark Tal Holland, D.C.
Title
Owner
Phone
(314) 867-8888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2002014997 MO Primary

Addresses

Primary practice location

10111 Lewis and Clark Blvd
Saint Louis, MO 63136-5562

Mailing address

10111 Lewis and Clark Blvd
Saint Louis, MO 63136-5562

National Provider Directory

National Provider Directory

Locations

10111 Lewis and Clark Blvd
Saint Louis, MO 63136
Phone (314) 867-8888

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1457308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1457308800000",
    "number": "1063872893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10111 LEWIS AND CLARK BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631365562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10111 LEWIS AND CLARK BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631365562",
            "telephone_number": "314-867-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIROPRACTIC OF NORTH COUNTY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-07",
        "last_updated": "2016-03-07",
        "status": "A",
        "authorized_official_last_name": "HOLLAND",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "TAL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-867-8888",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2002014997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2016; 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.