James Edward Lustig, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

004440 Issued in MO

Practice address

7472 Mexico Road
St Peters, MO 63376

Phone

(636) 279-1400

Fax

(636) 279-1408

NPI assigned

Sep 9, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Chiropractic

Education

Logan College of Chiropractic, 1979

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• JKL Enterprises Inc

  dba Mid Rivers Chiropractic

  • Multi-Specialty Clinic/Center
  • Saint Peters, MO
  • NPI 1407130347
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1157760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154425395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7472 MEXICO ROAD",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "636-279-1400",
            "fax_number": "636-279-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7472 MEXICO ROAD",
            "city": "ST PETERS",
            "state": "MO",
            "postal_code": "63376",
            "telephone_number": "636-279-1400",
            "fax_number": "636-279-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSTIG",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "MO",
            "license": "004440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "129105",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "4400458",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "9746",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC MED COMPLETE",
            "identifier": "00030913",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Saint Peters, MO
• Providers in Saint Peters, MO by specialty
• Chiropractor in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.