Individual provider Active NPI

Nghia Nguyen, DC

  • Chiropractor
  • Fulton, MO
National Provider Identifier
1104634757
Registry record updated Dec 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2024049947 Issued in MO
Practice address
621 Commons Dr
Fulton, MO 65251-1489
Phone
(573) 642-2273
NPI assigned
Dec 27, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2024049947 MO Primary

Addresses

Primary practice location

621 Commons Dr
Fulton, MO 65251-1489

Mailing address

621 Commons Dr
Fulton, MO 65251-1489
Phone (573) 642-2273

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
2024049947MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Koelling Family Chiropractic, PC Chiropractor CurrentSince Jan 2, 2025 Accepting new patients
Koelling Family Chiropractic Jeffcity Chiropractor CurrentSince Jan 2, 2025 Accepting new patients

Locations

621 Commons Dr
Fulton, MO 65251
Phone (573) 642-2273

3702 W Truman Blvd
Ste 218
Jefferson City, MO 65109
Phone (573) 310-9391

Organizations & group practices 2

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": "1735257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735257600000",
    "number": "1104634757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "621 COMMONS DR",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511489",
            "telephone_number": "573-642-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "621 COMMONS DR",
            "city": "FULTON",
            "state": "MO",
            "postal_code": "652511489",
            "telephone_number": "573-642-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "NGHIA",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-27",
        "last_updated": "2024-12-27",
        "certification_date": "2024-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2024049947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fulton, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2024; 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.