Individual provider Active NPI

Johnathan Lipe

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1073201463
Registry record updated Apr 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2023001638 Issued in MO
Practice address
8853 Ladue Rd
Saint Louis, MO 63124-2309
Phone
(314) 328-7960
NPI assigned
Apr 25, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 25, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2023001638 MO Primary

Addresses

Primary practice location

8853 Ladue Rd
Saint Louis, MO 63124-2309

Mailing address

1104 Reddick St
Perryville, MO 63775-2922

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2023001638MOMDChiropractor

NPI Registry JSON

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

{
    "created_epoch": "1682380800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682380800000",
    "number": "1073201463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1104 REDDICK ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752922"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8853 LADUE RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631242309",
            "telephone_number": "314-328-7960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIPE",
        "first_name": "JOHNATHAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-04-25",
        "last_updated": "2023-04-25",
        "certification_date": "2023-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2023001638",
            "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 Apr 25, 2023; 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.