Individual provider Active NPI

Paul Hyland, D.C.

  • Chiropractor
  • Creve Coeur, MO
National Provider Identifier
1154306066
Registry record updated Jul 2, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2005013007 Issued in MO
Practice address
13035 Olive Blvd
Suite 216
Creve Coeur, MO 63141-6173
Phone
(314) 542-2003
Fax
(314) 542-2007
NPI assigned
Dec 13, 2005
Last updated
Jul 2, 2008By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 2005013007 MO Primary

Addresses

Primary practice location

13035 Olive Blvd
Suite 216
Creve Coeur, MO 63141-6173

Mailing address

13035 Olive Blvd
Suite 216
Creve Coeur, MO 63141-6173
Phone (314) 542-2003

Other identifiers 3

IdentifierTypeStateIssuer
1061750-00OtherMOASH
681081OtherMOACN
201465OtherMOBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050919000623 MO Practitioner - Chiropractic 6204860307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Logan College of Chiropractic, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Committed to Health Chiropractic Center, LLCGroup PAC ID 3678671468, 2 clinicians

Practice addresses (Care Compare)

13035 Olive Blvd
Suite 216
Creve Coeur, MO 63141-6179
Phone (314) 542-2003

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2005013007MOMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Committed to Health Chiropractic Center, LLC Chiropractor CurrentSince Dec 27, 2005 Accepting new patients

Locations

1215 Fern Ridge Pkwy
Ste 204
Saint Louis, MO 63141
Phone (314) 542-2003

13035 Olive Blvd
Ste 216
Saint Louis, MO 63141
Phone (314) 542-2003

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": "1134432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214956800000",
    "number": "1154306066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13035 OLIVE BLVD",
            "address_2": "SUITE 216",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416173",
            "telephone_number": "314-542-2003",
            "fax_number": "314-542-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13035 OLIVE BLVD",
            "address_2": "SUITE 216",
            "city": "CREVE COEUR",
            "state": "MO",
            "postal_code": "631416173",
            "telephone_number": "314-542-2003",
            "fax_number": "314-542-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HYLAND",
        "first_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-12-13",
        "last_updated": "2008-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "2005013007",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ASH",
            "identifier": "1061750-00",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ACN",
            "identifier": "681081",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "201465",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Creve Coeur, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2008; 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.