Individual provider Active NPI

Ratchanop Vasant, D.C.

  • Chiropractor
  • O'Fallon, MO
National Provider Identifier
1114294832
Registry record updated Nov 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2011038219 Issued in MO
Practice address
2315 Technology Dr
Suite 107
O Fallon, MO 63368-7370
Phone
(636) 625-8894
NPI assigned
Nov 23, 2011
Last updated
Nov 23, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2011038219 MO Primary

Addresses

Primary practice location

2315 Technology Dr
Suite 107
O Fallon, MO 63368-7370

Mailing address

2315 Technology Dr
Suite 107
O Fallon, MO 63368-7370
Phone (636) 625-8894

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120125000420 MO Practitioner - Chiropractic 5496931545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Winghaven Chiropractic PC Chiropractor CurrentSince Dec 12, 2011 Accepting new patients

Locations

2315 Technology Dr
Ste 107
O Fallon, MO 63368
Phone (636) 625-8894

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1322006400000",
    "number": "1114294832",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2315 TECHNOLOGY DR",
            "address_2": "SUITE 107",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687370",
            "telephone_number": "636-625-8894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2315 TECHNOLOGY DR",
            "address_2": "SUITE 107",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687370",
            "telephone_number": "636-625-8894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VASANT",
        "first_name": "RATCHANOP",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-11-23",
        "last_updated": "2011-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2011038219",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in O'Fallon, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.