Active NPI
Thomas Lee Teter Jr, DC
- Sports Physician Chiropractor
- Kansas City, MO
National Provider Identifier
1144424946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Sports Physician Chiropractor
- License
- 2006002027
- Practice address
- 4635 Wyandotte St
Suite 205
Kansas City, MO 64112-1509 - Phone
- (816) 729-0947
- NPI assigned
- Jun 13, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 5025 | KS | |
| Sports Physician Chiropractor | 111NS0005X | 2006002027 | MO | Primary |
Addresses
Primary practice location
4635 Wyandotte St
Suite 205
Kansas City, MO 64112-1509
Mailing address
4635 Wyandotte St
Suite 205
Kansas City, MO 64112-1509
Phone (816) 729-0947
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5025 | Other | KS | KS LICENSE FOR DC |
| 2006002027 | Other | MO | LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5025 | KS | MD | Sports Physician Chiropractor |
| 2006002027 | MO | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Synergy Health and Wellness, PA | Past | Accepting new patients |
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.
-
- Chiropractor
- Prairie Village, KS
- NPI 1770885725
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1314748800000",
"number": "1144424946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4635 WYANDOTTE ST",
"address_2": "SUITE 205",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641121509",
"telephone_number": "816-729-0947"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4635 WYANDOTTE ST",
"address_2": "SUITE 205",
"city": "KANSAS CITY",
"state": "MO",
"postal_code": "641121509",
"telephone_number": "816-729-0947"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TETER JR",
"first_name": "THOMAS",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "DC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-06-13",
"last_updated": "2011-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "KS",
"license": "5025",
"primary": false
},
{
"code": "111NS0005X",
"taxonomy_group": "",
"desc": "Chiropractor, Sports Physician",
"state": "MO",
"license": "2006002027",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KS LICENSE FOR DC",
"identifier": "5025",
"state": "KS"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LICENSE",
"identifier": "2006002027",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kansas City, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.