Individual provider Active NPI

Carolyn Griffin, D.C.

  • Chiropractor
  • Saint Charles, MO
National Provider Identifier
1063958510
Registry record updated Oct 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2016039200 Issued in MO
Practice address
222 S 2ND St
Saint Charles, MO 63301-2809
Phone
(314) 566-4282
NPI assigned
Jan 9, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2016039200 MO Primary

Addresses

Primary practice location

222 S 2ND St
Saint Charles, MO 63301-2809

Mailing address

222 S 2ND St
Saint Charles, MO 63301-2809
Phone (314) 566-4282

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190821004827 MO Practitioner - Chiropractic 7719215227 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

222 S 2ND St
Saint Charles, MO 63301-2809
Phone (636) 345-4565

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2016039200MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Carolyn S. Griffin, DC, LLC Chiropractor CurrentSince Jul 10, 2019 Accepting new patients
Perez Family Chiropractic LLC Chiropractor Past Accepting new patients
Active Family Chiropractic, LLC PastSince Aug 1, 2019 Accepting new patients

Locations

222 S 2nd St
Ste 2
Saint Charles, MO 63301

222 S 2nd St
Saint Charles, MO 63301
Phone (636) 345-4565

1404 Triad Center Dr
Saint Peters, MO 63376
Phone (636) 352-0380

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1483920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665619200000",
    "number": "1063958510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 S 2ND ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012809",
            "telephone_number": "314-566-4282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 S 2ND ST",
            "city": "SAINT CHARLES",
            "state": "MO",
            "postal_code": "633012809",
            "telephone_number": "314-566-4282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "CAROLYN",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-09",
        "last_updated": "2022-10-13",
        "certification_date": "2022-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2016039200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Charles, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2022; 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.