Organization Active NPI

Cheryl Shea, DC PC

  • Chiropractor
  • Saint Louis, MO
National Provider Identifier
1124208103
Registry record updated Nov 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2004004115 Issued in MO
Legal business name
CHERYL SHEA, DC PC
Practice address
10807 Big Bend Rd
Saint Louis, MO 63122-6054
Phone
(314) 822-7900
NPI assigned
Nov 7, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2007

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

Authorized official

Name
Cheryl Shea, DCNPI 1225068745
Title
Owner
Phone
(314) 822-7900

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2004004115 MO Primary

Addresses

Primary practice location

10807 Big Bend Rd
Saint Louis, MO 63122-6054

Mailing address

10807 Big Bend Rd
Saint Louis, MO 63122-6054
Phone (314) 822-7900

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20071204000488 MO Part B Supplier - Clinic/Group Practice 1254420896 Receives reassigned benefits from 1 practitioner
Practice locations: Kirkwood, MO

National Provider Directory

National Provider Directory

Locations

10807 Big Bend Rd
Saint Louis, MO 63122
Phone (314) 269-3847

Practitioners & affiliated clinicians

Practitioners 1

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": "1194393600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194393600000",
    "number": "1124208103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10807 BIG BEND RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226054",
            "telephone_number": "314-822-7900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10807 BIG BEND RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631226054",
            "telephone_number": "314-822-7900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHERYL SHEA, DC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-07",
        "last_updated": "2007-11-07",
        "status": "A",
        "authorized_official_last_name": "SHEA",
        "authorized_official_first_name": "CHERYL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "314-822-7900",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2004004115",
            "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 Nov 7, 2007; 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.