Organization Active NPI

Wiethop Chiropractic, LLC

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1083813091
Registry record updated Jul 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2007001660 Issued in MO
Legal business name
WIETHOP CHIROPRACTIC, LLC
Practice address
12032 Tesson Ferry Rd
Suite 100
Saint Louis, MO 63128-1774
Phone
(314) 849-1331
Fax
(314) 842-9899
NPI assigned
Jul 11, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2007

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

Authorized official

Name
Justin Wiethop, D.C.
Title
Owner/Manager
Phone
(314) 849-1331

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2007001660 MO Primary

Addresses

Primary practice location

12032 Tesson Ferry Rd
Suite 100
Saint Louis, MO 63128-1774

Mailing address

12032 Tesson Ferry Rd
Suite 100
Saint Louis, MO 63128-1774
Phone (314) 849-1331

National Provider Directory

National Provider Directory

Locations

12032 Tesson Ferry Rd
Ste 100
Saint Louis, MO 63128
Phone (314) 843-8590

Practitioners & affiliated clinicians

Practitioners 2

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": "1184112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184112000000",
    "number": "1083813091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12032 TESSON FERRY RD",
            "address_2": "SUITE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281774",
            "telephone_number": "314-849-1331",
            "fax_number": "314-842-9899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12032 TESSON FERRY RD",
            "address_2": "SUITE 100",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631281774",
            "telephone_number": "314-849-1331",
            "fax_number": "314-842-9899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WIETHOP CHIROPRACTIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-07-11",
        "status": "A",
        "authorized_official_last_name": "WIETHOP",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER/MANAGER",
        "authorized_official_telephone_number": "314-849-1331",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2007001660",
            "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 Jul 11, 2007; 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.