Individual provider Active NPI

Xaivier T Tipler, D.C.

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1114089133
Registry record updated Sep 29, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2006030819 Issued in MO
Practice address
305 Union Blvd
Saint Louis, MO 63108-1229
Phone
(314) 361-4650
Fax
(314) 361-4663
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2006030819 MO Primary

Addresses

Primary practice location

305 Union Blvd
Saint Louis, MO 63108-1229

Mailing address

1151 Marcus Aurelius Walk Apt B
Chesterfield, MO 63017-3058
Phone (314) 878-5997

Other identifiers 3

IdentifierTypeStateIssuer
299371OtherMOGHP PIN
000000218562OtherMOBLUE CROSS PIN
425559OtherMOWELLCARE PIN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070706000021 MO Practitioner - Chiropractic 8123128097 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2050 Woodson Rd
Suite 101
Overland, MO 63114-5644
Phone (314) 447-0725

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2006030819MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Proficient Chiropractic West End Chiropractor CurrentSince Apr 8, 2025 Accepting new patients
Tipler Chiropractic & Rehabilitation, Inc Chiropractor CurrentSince Jul 1, 2010 Accepting new patients
Proficient Wellness LLC PastSince Oct 28, 2020 Accepting new patients

Locations

305 Union Blvd
Saint Louis, MO 63108
Phone (314) 296-3075

2050 Woodson Rd
#101
Saint Louis, MO 63114
Phone (314) 447-0725

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1285718400000",
    "number": "1114089133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1151 MARCUS AURELIUS WALK APT B",
            "city": "CHESTERFIELD",
            "state": "MO",
            "postal_code": "630173058",
            "telephone_number": "314-878-5997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 UNION BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631081229",
            "telephone_number": "314-361-4650",
            "fax_number": "314-361-4663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIPLER",
        "first_name": "XAIVIER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2010-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2006030819",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHP PIN",
            "identifier": "299371",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PIN",
            "identifier": "000000218562",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE PIN",
            "identifier": "425559",
            "state": "MO"
        }
    ],
    "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 Sep 29, 2010; 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.